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Effect of integrative mobile health intervention in patients with hypertension and diabetes: a crossover study (Preprint)


 BACKGROUND
 Obesity, hypertension and type 2 diabetes mellitus (T2DM) are worldwide epidemics that inflict burdens on both public health and healthcare costs. Self-management plays an important role in the proper management of the three chronic diseases, and in this context, mobile health (mHealth) can be a cost-effective self-management tool
 
 
 OBJECTIVE
 The aim of this trial was to evaluate the effect of integrative mHealth on improving health status in patients aged 40 to 70 years old with T2DM and/or hypertension and controlled with pharmacotherapy.
 
 
 METHODS
 This trial was performed in a controlled, randomized, three-months two-period crossover design to test the efficacy of integrative mHealth compared to conventional treatment in T2DM with/without hypertension and obesity. Integrative mHealth was composed of four parts; 1) self-measuring devices, 2) smartphone applications that gathered lifestyle data, gave them feedback, health information, drug information and medication schedule, 3) unmanned kiosks, and 4) web-based access of participants’ health information.
 
 
 RESULTS
 The input rates of food intake and exercise to smartphone app were very low (24.9% and 5.3%, respectively). On the contrary, the input rate of taking medicine to application was high (84.0%). There were no significant differences of changes in body weight, BMI, body composition, blood pressure and HbA1c between integrative mHealth and conventional treatment groups. However, in proportion to the elevation of the input rate of taking medicine, body fat mass and HbA1c were lowered in the integrative mHealth group (P<0.05).
 
 
 CONCLUSIONS
 In conclusion, while smartphone application can influence body fat and blood glucose, it failed to show clinical improvement. Higher input rate of taking medicine was related to significantly lower body fat mass and HbA1c.
