Smart Phones Help Manage Chronic Illness
Wednesday, September 7, 2011
By Emily Singer
Apps that connect to medical monitors have been shown to
improve the health of people with
diabetes and hypertension—and could ease the burden on the health-care system.
App stores are exploding with programs designed to
help people monitor their health using a
smart phone. But the majority of these apps merely make it easier for patients to record health
measures, such as weight or blood pressure. It's unclear if they actually significantly improve
, a biomedical engineer at the University Health Network, in Toronto, and
collaborators have developed apps that do much more. Their apps interface wirelessly with
a blood-pressure monitor and a blood-sugar monitor—and offer
suggestions based on the readings. They found that people using the programs lowered their
blood pressure and were more vigilant about monitoring and testing their blood sugar.
One of the most interesting findings was that doctors seemed to play no role in the change. "It
was solely patients becoming
responsible for their own care," says Cafazzo, who heads the
university's Centre for Global eHealth Innovation.
Cafazzo's efforts were partly a result of the growing use of smart phones as medical tools, as well
as an increase in remote and home monitoring devices that are moving medicine outside the
But unlike many existing monitoring systems, Cafazzo sees his work bringing greater
responsibility to the patient. "
The goal of classic home monitoring is to collect information and
deliver it to the doctor, who has to analyze and act on it, then return that information to the
patient," he says. "It's not really self-care."
In a yearlong clinical trial of the system involving 110 patients with diabetic hypertension,
Cafazzo and colleagues had some people use the app and a home blood-pressure monitor, while
others used only a monitor.
Those who used the app had a drop in systolic blood pressure of 10
millimeters of mercury, on average, which would reduce the risk of cardiac events by about 25
percent. Those who used just the conventional pressure monitor saw no reduction in blood
Physicians didn't significantly alter patients' medication or treatment regimens during the course
of the study, so researchers say any changes in health must have been solely due to the
monitoring app and related changes in patient behavior, such as new eating patterns and better
medication compliance. "Just giving the monitor isn't enough," says Cafazzo. "
telemonitoring keeps patients engaged."
The app highlights trends in blood-pressure readings and detects when people forget to take their
measurements, reminding them with an automated phone call. Giving patients self-monitoring
tools makes them aware of their health stats on a daily basis, rather than just in the week before a
doctor's appointment, says Cafazzo. This is especially relevant for hypertension, which doesn't