Study Pairs Mobile Technology With Expert Review
Oct 01, 2019 Cedars-Sinai Staff
During a three-month pilot study currently underway, patients will take their blood pressure and, with a tap of a button on their smartphone, email the results to their doctor. The physician will use that information to monitor how well the patients' prescription plan is working, and make adjustments based on the continual readings.
This new approach—observing patients through technology and adjusting medications on the go—may be key to preventing chronic hypertension's most dangerous outcomes, such as heart attack and stroke, said the study's principal investigator, cardiologist Florian Rader, MD, MSc.
"Whether it's in research or clinical care, it's all about teams now. No one provider, no one nurse can do everything."
“Mobile technology, home monitoring and sending doctors this information is the future of where medicine is going,” he said.
According to Rader, using available technology to aid in the control of hypertension is a completely novel approach—a shift from paternalistic, in-office treatment to more patient-centered, self-directed care.
Patients in the study will use a free iPhone app, Withings Health Mate, along with the Withings iPhone Blood Pressure Cuff to take their readings wherever they are most comfortable. The app will remind them to do so twice daily, and send the results to Rader and his team for review.
“It has been shown that out-of-office blood pressure is actually more important in predicting BAT (baroreflex activation therapy) cardiac outcomes compared to blood pressure taken in the office,” he noted. “That is the blood pressure you have all day long versus in the office where you may be nervous; you may have this white-coat effect and that does not predict BAT outcomes as good as home blood pressure.”
"A team of people from differing specialties and backgrounds improves individualized patient care," said Phillips, executive vice chair of the Department of Surgery and the chief of General Surgery. "From diagnosis to treatment, the ‘disease' is different in every patient."
After initial screening and basic testing, the patient may undergo a procedure known as adrenal vein sampling, a highly accurate diagnostic tool that requires an exceptionally skilled interventional radiologist. The specialized technique, which is performed at Cedars-Sinai by Friedman, helps determine whether the problem is isolated on one side of the body, or if it's occurring in both glands. This helps the team determine what kind of treatment plan to pursue.
Friedman said the type of multidisciplinary collaboration employed by Team Aldo is becoming increasingly important in the practice of medicine.
Ronald G. Victor, MD, director of the Hypertension Center and associate director of Clinical Research for the Heart Institute, said the beauty of this approach is that it's easy and convenient.
“This use of mobile technology is the way of the future,” Victor said. “It's coming of age big time and I think a lot of the new movement is to use telemedicine, especially since smart phones are so easy.”
“It's all in the app,” he said. “The patient can just hit one button and the doctor gets the results in a spread sheet via text message or email.”
The cuff can be used with iPhone 3GS, 4 or 4S. An adapter is required for iPhone 5.
“It's very easy to use. You can bring the cuff to work or wherever you're going. It's very portable and it's a cool looking device,” Rader said. “It's kind of fun.”
If the method proves to be safe and effective, Rader said the hope is it will lead to a change in the way physicians approach hypertension treatment overall.
"A lot of people have (an iPhone) and people are involved with their phones anyways,” he said. “They look at it all day and so if you can use it for something good, for your body, then (it will) hopefully remind people to check their blood pressure.”
The study is currently enrolling participants. Please contact the Hypertension Center for more information.