跳到主要內容

簡易檢索 / 詳目顯示

研究生: 戴崇宇
Chung-Yu Dai
論文名稱: 行動照護對慢性病患者血壓影響之研究
Impact of mHealth on Blood Pressure in Patients with Chronic Diseases
指導教授: 陳炫碩
Shiuann-Shuoh Chen
口試委員:
學位類別: 碩士
Master
系所名稱: 管理學院 - 企業管理學系
Department of Business Administration
論文出版年: 2024
畢業學年度: 112
語文別: 英文
論文頁數: 35
中文關鍵詞: 行動醫療應用程式血壓高血壓病患自我管理
外文關鍵詞: mHealth, mobile app, blood pressure, hypertension, patient self-management
相關次數: 點閱:12下載:0
分享至:
查詢本校圖書館目錄 查詢臺灣博碩士論文知識加值系統 勘誤回報
  • 高血壓是心血管疾病、腦中風、糖尿病、腎臟病等重大慢性病的共同危險因子,也是目前全球疾病負擔(globalburdenofdisease)排名的首位。在台灣,18歲以上國人的高血壓盛行率達26.8%,且盛行率會隨年齡增加而上升。在科技進步迅速的數位時代,使用行動照護(mHealth)便是一個可以很有效率的監控自身身體狀況的方式,當然血壓也不例外。截至2021年,在主要手機平台上架的mHealthapp的數量已經超過了35萬個。然而,在台灣卻鮮少有研究者針對mHealth對於慢性病病患血壓的影響來進行研究。因此,本研究透過與台灣本地的醫院合作,收集了66位慢性病病患的健康資料,並以多元線性回歸模型來分析病患的血壓與「是否使用mHealth」、「使用頻率」以及「使用天數」之間的關聯性。我們的研究結果發現,在使用mHealth的情況下,量測次數越多,血壓也會越低。但相反的,我們也發現使用mHealth本身與mHealth的使用天數與病患的血壓並沒有顯著的關聯性。因此,我們認為要發揮mHealth最大效益的前提,就是病患要持續穩定的進行自主量測。


    Hypertension is a common risk factor for major chronic diseases such as cardiovasculardisease, stroke, diabetes, and kidney disease. It currently ranks as the leading contributor to theglobal burden of disease. In Taiwan, the prevalence of hypertension among individuals aged 18and above is 26.8%, and the prevalence increases with age. In this era of rapid technologicaladvancement, mobile health (mHealth) has emerged as an effective means of monitoring one'shealth status, including blood pressure. As of 2021, there are over 350,000 mHealth appsavailable on major mobile platforms. However, there is limited research in Taiwan thatspecifically examines the impact of mHealth on blood pressure among patients with chronicdiseases. Therefore, this study collaborated with local hospitals in Taiwan to collect health datafrom 66 patients with chronic diseases and used a multiple linear regression model to analyzethe relationship between patients' blood pressure and their use of mHealth, frequency of use,and duration of use. Our research findings indicate that with the use of mHealth, highermeasurement frequency is associated with lower blood pressure. Conversely, we found nosignificant association between the use of mHealth itself or the duration of use and patients'blood pressure. Therefore, we believe that for mHealth to be maximally beneficial, patientsneed to consistently and independently monitor their blood pressure.

    中文摘要 ..................................................................................................................................... i Abstract ...................................................................................................................................... ii CONTENTS .............................................................................................................................. iii LIST OF FIGURES ................................................................................................................. iv LIST OF TABLES .................................................................................................................... iv Chapter 1 Introduction ......................................................................................................... 1 Chapter 2 Hypothesis & Related Work ................................................................................ 4 2.1 Benefit of mHealth ..................................................................................................... 4 2.2 The Frequency of Blood Pressure Measurements: ................................................. 4 2.3 The Time Staying with The Program ...................................................................... 5 Chapter 3 Methods ................................................................................................................ 7 3.1 Data Background ....................................................................................................... 7 3.2 Data Processing .......................................................................................................... 9 3.3 Analyzing Data ......................................................................................................... 11 3.4 White Coat Effect ..................................................................................................... 12 Chapter 4 Results & Discussion ......................................................................................... 13 4.1 Descriptive Statistics ................................................................................................ 13 4.2 Results of Multiple Linear Regression ................................................................... 13 4.2.1 Systolic Blood Pressure ................................................................................................................... 13 4.2.2 Diastolic Blood Pressure ................................................................................................................. 15 4.3 Results of Paired Sample T-test .............................................................................. 15 4.4 Results of White Coat Effect ................................................................................... 16 4.5 Discussion ................................................................................................................. 17 Chapter 5 Conclusion ......................................................................................................... 18 5.1 Conclusion ................................................................................................................ 18 5.2 Limitations and Future Directions ......................................................................... 19 Reference.................................................................................................................................. 21 Appendix .................................................................................................................................. 26

    1. GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and
    injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global
    Burden of Disease Study 2019. Lancet 2020;396:1204–1222.
    2. GBD 2016 Causes of Death Collaborators. Global, regional, and national agesex specific
    mortality for 264 causes of death, 1980–2016: a systematic analysis for the Global
    Burden of Disease Study 2016. Lancet 2017;390:1151–1210.
    3. NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in blood pressure from
    1975 to 2015: a pooled analysis of 1479 population-based measurement studies with 191
    million participants. Lancet 2017;389:37–55.
    4. GBD 2019 Risk Factors Collaborators. Global burden of 87 risk factors in 204 countries
    and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study
    2019. Lancet 2020;396:1223–1249.
    5. Wolf-Maier K, Cooper RS, Kramer H, Banegas JR, Giampaoli S, Joffres MR, Poulter N,
    Primatesta P, Stegmayr B, Thamm M. Hypertension treatment and control in five
    European Countries, Canada, and the United States. Hypertension 2004;43:10–17.
    6. van Kleef ME, Spiering W. Hypertension: overly important but under-controlled. Eur J
    Prev Cardiol 2017;24:36–43.
    7. Nerenberg, K. A., Zarnke, K. B., Leung, A. A., Dasgupta, K., Butalia, S., McBrien,
    K., ... & Canada, H. (2018). Hypertension Canada’s 2018 guidelines for diagnosis, risk
    assessment, prevention, and treatment of hypertension in adults and children. Canadian
    Journal of Cardiology, 34(5), 506-525.
    8. Williams, B., Mancia, G., Spiering, W., Agabiti Rosei, E., Azizi, M., Burnier, M., ... &
    Desormais, I. (2018). 2018 ESC/ESH Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the
    European Society of Cardiology (ESC) and the European Society of Hypertension (ESH).
    European heart journal, 39(33), 3021-3104.9. Whelton, P. K., Carey, R. M., Aronow, W. S., Casey, D. E., Collins, K. J., Dennison
    Himmelfarb, C., ... & Wright, J. T. (2018). 2017
    ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the
    prevention, detection, evaluation, and management of high blood pressure in adults: a
    report of the American College of Cardiology/American Heart Association Task Force
    on Clinical Practice Guidelines. Journal of the American College of Cardiology, 71(19),
    e127-e248.
    10. Patnode CD, Evans CV, Senger CA, Redmond N, Lin JS. Behavioral counseling to
    promote a healthful diet and physical activity for cardiovascular disease prevention in
    adults without known cardiovascular disease risk factors: updated evidence report and
    systematic review for the US Preventive Services Task Force. JAMA 2017;318:175–193.
    11. Schwingshackl L, Chaimani A, Schwedhelm C, Toledo E, Pu¨nsch M, Hoffmann G,
    Boeing H. Comparative effects of different dietary approaches on blood pressure in
    hypertensive and pre-hypertensive patients: a systematic review and network metaanalysis.
    Crit Rev Food Sci Nutr 2019;59:2674–2687.
    12. Pickering TG, Miller NH, Ogedegbe G, Krakoff LR, Artinian NT, Goff D; American
    Heart Association; American Society of Hypertension; Preventive Cardiovascular Nurses
    Association. Call to action on use and reimbursement for home blood pressure
    monitoring: a joint scientific statement from the American heart association, American
    society of hypertension, and preventive cardiovascular nurses association. J Cardiovasc
    Nurs. 2008;23:299–323. doi: 10.1097/01.JCN.0000317429.98844.04
    13. Elliott WJ. What factors contribute to the inadequate control of elevated blood pressure?
    J Clin Hypertens (Greenwich). 2008;10(1 suppl 1):20–26.14. Burnier M, Egan BM. Adherence in hypertension. Circ Res. 2019;124:1124–1140. doi:
    10.1161/CIRCRESAHA.118.313220
    15. Leon N, Surender R, Bobrow K, Muller J, Farmer A. Improving treatment adherence for
    blood pressure lowering via mobile phone SMS messages in South Africa: a qualitative
    evaluation of the SMS-text Adherence SuppoRt (StAR) trial. BMC Fam Pract.
    2015;16:80. doi: 10.1186/s12875-015-0289-7
    16. Kamal AK, Shaikh Q, Pasha O, et al. A randomized controlled behavioral intervention
    trial to improve medication adherence in adult stroke patients with prescription tailored
    Short Messaging Service (SMS)-SMS4Stroke study. BMC Neurol. 2015;15:212. doi:
    10.1186/s12883-015-0471-5
    17. Petrella RJ, Stuckey MI, Shapiro S, Gill DP. Mobile health, exercise and metabolic risk:
    a randomized controlled trial. BMC Public Health. 2014;14:1082. doi: 10.1186/1471-
    2458-14-1082
    18. Wang W, Li D, Shi W, Zhang J, Sui J. Research on the application of mobile health D2C
    model in the management of hypertensive disease in grassroots community. Chin J Gen
    Practic. 2017;7:1194–1197.
    19. Rehman H, Kamal AK, Morris PB, Sayani S, Merchant AT, Virani SS. Mobile health
    (mHealth) technology for the management of hypertension and hyperlipidemia: slow
    start but loads of potential. Curr Atheroscler Rep. 2017; 19(3):12.
    20. The penetration rate of mobile phone. Iran: Irna. Cited 2020 10 Jan.
    21. Global smartphone penetration data. Accessed 10 Jan 2020.
    22. Diez-Canseco F, Zavala-Loayza JA, Beratarrechea A, Kanter R, Ramirez-Zea M,
    Rubinstein A, Martinez H, Miranda JJ. Design and multi-country validation of text
    messages for an mHealth intervention for primary prevention of progression to
    hypertension in Latin America. JMIR Mhealth Uhealth. 2015; 3(1):e19.23. Estrin, D., and Sim, I. 2010. “Open mHealth Architecture: An Engine for Health Care
    Innovation.” Science (330:6005), pp.759-76
    24. Manyika, J., Chui, M., Bughin, J., Dobbs, R., Bisson, P., and Marrs, A. 2013.
    “Disruptive Technologies: Advances That Will Transform Life, Business, and the Global
    Economy,” Report, McKinsey Global Institute.
    25. Steinhubl, S. R., Muse, E. D. & Topol, E. J. Can mobile health technologies transform
    health care? J. Am. Med. Assoc. 310, 2395–2396 (2013).
    26. de Jongh, T., Gurol-Urganci, I., Vodopivec-Jamsek, V., Car, J. & Atun, R. Mobile phone
    messaging for facilitating self-management of long-term illnesses. Cochrane Database
    Syst. Rev. 12, CD007459 (2012).
    27. Bonoto, B. C. et al. Efficacy of mobile apps to support the care of patients with diabetes
    mellitus: a systematic review and meta-analysis of randomized controlled trials. JMIR
    MHealth UHealth 5, e4 (2017).
    28. Widmer, R. J. et al. Digital health interventions for the prevention of cardiovascular
    disease: a systematic review and meta-analysis. Mayo Clin. Proc. 90, 469–480 (2015).
    29. Ambrosius, Walter T, Kaycee M Sink, Capri G Foy, Dan R Berlowitz, Alfred K Cheung,
    William C Cushman, Lawrence J Fine, et al. "The Design and Rationale of a Multicenter
    Clinical Trial Comparing Two Strategies for Control of Systolic Blood Pressure: The
    Systolic Blood Pressure Intervention Trial (Sprint)." Clinical Trials 11, no. 5 (2014):
    532-46.
    30. National Heart, Lung, and Blood Institute. "Landmark Nih Study Shows Intensive Blood
    Pressure Management May Save Lives." Press release 11 (2015).
    31. Whelton, Paul K, Robert M Carey, Wilbert S Aronow, Donald E Casey, Karen J Collins,
    Cheryl Dennison Himmelfarb, Sondra M DePalma, et al. "2017 Acc/Aha/
    Aapa/Abc/Acpm/Ags/Apha/Ash/Aspc/Nma/Pcna Guideline for the Prevention,Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of
    the American College of Cardiology/American Heart Association Task Force on Clinical
    Practice Guidelines." Journal of the American College of Cardiology 71, no. 19 (2018):
    e127-e248.
    32. Patel, Pragna, Pedro Ordunez, Donald DiPette, Maria Cristina Escobar, Trevor Hassell,
    Fernando Wyss, Anselm Hennis, et al. "Improved Blood Pressure Control to Reduce
    Cardiovascular Disease Morbidity and Mortality: The Standardized Hypertension
    Treatment and Prevention Project." The Journal of Clinical Hypertension 18, no. 12
    (2016): 1284-94.
    33. Yue Dai, YaliWang, Yanxia Xie, Jia Zheng, Rongrong Guo, Zhaoqing Sun, Liying
    Xing , Xingang Zhang, Yingxian Sun , and Liqiang Zheng, “Short-Term and Long-Term
    Blood Pressure Changes and the Risk of All-Cause and Cardiovascular Mortality”
    BioMed Research International (2019)
    34. Anindya Ghose, Xitong Guo, Beibei Li, Yuanyuan Dang, “Empowering Patients Using
    Smart Mobile Health Platforms: Evidence From a Randomized Field Experiment” MIS
    Quarterly Vol. 46 No. 1 pp. 151-191 / March (2022)
    35. George Stergiou, Anastasios Kollias, Gianfranco Parati, Eoin O’Brien, “The Weak
    Cornerstone of Hypertension Diagnosis” Office Blood Pressure Measurement (2023)
    36. Elisabete Pinto “Blood pressure and aging” National Library of Medicine (2007)

    QR CODE
    :::