A content analysis of smartphone-based applications for hypertension management

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Abstract

Smartphone–based medical applications (apps) can facilitate self–management of hypertension (HTN). The content and consumer interaction metrics of HTN–related apps are unknown. In this cross–sectional study to ascertain the content of medical apps designed for HTN management, we queried Google Play and Apple iTunes using the search terms “hypertension” and “high blood pressure.” The top 107 apps were analyzed. Major app functionalities including tracking (for blood pressure [BP], pulse, weight, body mass index), medical device (to measure pulse or BP), general information on HTN, and medication adherence tools were recorded along with consumer engagement parameters. Data were collected from May 28 to May 30, 2014. A total of 72% of the apps had tracking function, 22% had tools to enhance medication adherence, 37% contained general information on HTN, and 8% contained information on Dietary Approaches to Stop Hypertension (DASH) diet. These data showed that a majority of apps for HTN are designed primarily for health management functions. However, 14% of Google Android apps could transform the smartphone into a medical device to measure BP. None of these apps employed the use of a BP cuff or had any documentation of validation against a gold standard. Only 3% of the apps were developed by healthcare agencies such as universities or professional organizations. In regression models. the medical device function was highly predictive of greater number of downloads (odds ratio, 97.08; P < .001) and positive consumer reviews (Incidence rate ratios, 1204.39; P < .001). A large majority of medical apps designed for HTN serve health management functions such as tracking blood pressure, weight, or body mass index. Consumers have a strong tendency to download and favorably rate apps that are advertised to measure blood pressure and heart rate, despite a lack of validation for these apps. There is a need for greater oversight in medical app development for HTN, especially when they qualify as a medical device.

First review

Introduction

Mobile health, or m-health technologies, can help treat the symptoms of hypertension (HTN), especially blood pressure (BP). However, the content of hypertension (HTN) smartphone-based apps are unknown. 107 apps from the Google Play and the Apple App store were analyzed. [1]

Methods

In Google play and Apple App stores, the keywords "hypertension" and "high blood pressure" were searched. The top 50 apps were selected for each term, giving a total of 200 apps and 107 unique apps. They recorded the average rating, number of ratings, and number of downloads per app. Then they analyzed the functional characteristics of each mobile healthcare app, such as hypertension education, tracking function, medication adherence tools, whether the app can make the smartphone a blood pressure reader or heart rate monitor, and access to support forums of people with hypertension.

Interesting to me results

Most of the apps targeted patients (95.3%) and were tracking devices (71.9%). 69.1% could track blood pressure, and 61.7% could track heart rate. 66.3% had analytical tools that could tell you about trends in blood pressure and heart rate, like text-based feedback tools that would tell you if your blood pressure were too high. 43.9% could export information from the app to an excel file and send it to your email.

something cool

14% of the Android apps (7 of them) could turn your phone into a blood pressure or heart rate monitor. It was cuffless, and all you had to do was press your finger against the screen. None had a documentation of gold-standard validation and none were approved as measuring devices by the FDA.

Conclusion

Over 90% of apps are targeted towards patients. Almost 3/4 of hypertension apps can record and track blood pressure and/or heart rate. Almost one half can export data out from the app.

My comments

I think it's great that there are so many apps targeted towards patients with hypertension, and a lot of those apps have fundamental functionalities such as blood pressure and heart rate tracking, and a significant number of apps also have analytical tools to help the patient know if their blood pressure is too high or something of that nature. The FDA is increasingly regulating such apps, and it will be interesting to see how it affects the marketplace of these apps.

Second review

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References

  1. Kumar, 2015. A content analysis of smartphone-based applications for hypertension management http://www.ncbi.nlm.nih.gov/pubmed/25660364