Hypertension Assessment and Management: Role for Digital Medicine
Open accessAbstract
To the Editor: Current control rates are far below the Healthy People goal of 50%, which was originally set as the year 2000 goal and has since been extended.1 Treatment has generated a benefit-to-cost ratio of at least 6:1, but much more can be achieved.More effective use of antihypertensive medication would have an impact on mortality akin to eliminating all deaths from medical errors or accidents.2 Poor adherence to antihypertensive therapy is a major cause of lack of blood pressure control.At the core of clinical decisions for individual management is a need for ready identification of individuals who remain uncontrolled, or appear to require a considerable pharmaceutical burden to achieve control, and whether nonadherence or pharmacologic unresponsiveness is the root cause.We wish to describe the first use of a commercially available digital health feedback system (Helius; Proteus Digital Health, Inc, Redwood City, CA) to assess hypertension therapy.It consists of a poppy-sized ingestible sensor made of foodstuff, and a wearable sensor (also called "Patch") that may be utilized for 7day wear during all activities including exercising and bathing.The patch automatically logs and stores the dates and times of ingestible sensor ingestion and activities of daily living.The Patch is capable of automatically transmitting its stored data to a compatible computerized device for display, or having its stored data downloaded after completion of its use.We invited 8 of our patients who were taking chronic antihypertensive treatment to utilize the system for a 2week period.Patients wore the wearable sensor continuously, with replacement after 1 week, and ingested the ingestible sensor daily whenever they took their prescribed antihypertensive drugs.Ingestible sensor use was downloaded from each Patch after its use for correlation with blood pressure determinations that were made at the time of clinic visits before, during, and at the end of system use.Our patients included 5 men, aged 49 to 62 years, with essential hypertension.All patients were prescribed long-term antihypertensive treatment.After 2 weeks of product use, taking adherence (ie, number of ingestible sensors detected divided by the total number prescribed) ranged from 70% to 100%, and timing adherence (ie, number of ingestible sensors
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The uncontrolled prior studies did not focus on disease control.
“However, these uncontrolled studies did not focus on disease control.”
From Effectiveness of Digital Medicines to Improve Clinical Outcomes in Patients with Uncontrolled Hypertension and Type 2 Diabetes: Prospective, Open-Label, Cluster-Randomized Pilot Clinical Trial (2017) · cites this paper as [21]
The Abstract (page not given) frames the study around identifying patients whose hypertension remains uncontrolled. It reports blood-pressure measurements during system use and says the findings informed treatment decisions to improve blood pressure. That is contrary to the claim that the study did not focus on disease control. (LLM, conf=0.84)
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Experimental — accuracy not yet measuredPrior clinical studies demonstrated the accuracy, safety, and feasibility of using the DMO in patients across a range of medical conditions, including hypertension and type 2 diabetes mellitus.
“Prior clinical studies demonstrated the accuracy, safety, and feasibility of using the DMO in patients across a range of medical conditions, including HTN and type 2 diabetes mellitus (T2DM)”
From Effectiveness of Digital Medicines to Improve Clinical Outcomes in Patients with Uncontrolled Hypertension and Type 2 Diabetes: Prospective, Open-Label, Cluster-Randomized Pilot Clinical Trial (2017) · cites this paper as [21]
The Abstract reports use of the digital system in eight patients with hypertension and describes it as informative and easy to use, supporting feasibility in that group. It does not report patients with type 2 diabetes or establish the system’s accuracy or safety across medical conditions. (LLM, conf=0.86)
Experimental — accuracy not yet measuredPrior clinical studies suggested this DMO can identify reasons for uncontrolled hypertension and help patients achieve blood pressure control.
“and suggested this DMO can identify reasons for uncontrolled HTN and help patients achieve BP control [16-21].”
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Cites
The Value Of Antihypertensive Drugs: A Perspective On Medical Innovation
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Digital Pills with Ingestible Sensors: Patent Landscape Analysis
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- Authors
- Godbehere, P., & Wareing, P.
- Affiliations
- North Brink Practice Cambridgeshire UK
- Venue
- The Journal of Clinical Hypertension
- Publisher
- Wiley
- Published
- 2014-02-05
- Volume
- 16
- Issue
- 3
- Pages
- 235-235
- ISSN
- 1524-6175 (ISSN-L)
- 1751-7176
- PMC
- PMC8032103
- OpenAlex
- W2049768988
- Cited by
- 10
- References
- 1
- Citations by year
- 2022: 1 · 2020: 1 · 2019: 1 · 2018: 2 · 2017: 3 · 2016: 2
- FWCI
- 1.14
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Clinical Hypertension (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Keywords
- hypertension, antihypertensive medication adherence, ingestible sensors, wearable sensors, blood pressure control, essential hypertension, timing of drug administration, Helius
- MeSH terms
- Essential Hypertension, Antihypertensive Agents, Attitude of Health Personnel, Biotechnology, Blood Pressure, Humans, Hypertension, Male, Middle Aged, Patient Compliance, Biosensing Techniques, Treatment Outcome, Patient Satisfaction
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