Mobile health reduces CVD risk behaviors

An American Heart Association (AHA) Scientific Statement of a review of 69 studies shows the feasibility and preliminary efficacy of using mobile health (mHealth) technologies to reduce CVD risk behaviors (Burke et al. Circulation 2015).

This was the cornerstone of a presentation entitled “mHealth in Practice: Reality or Pipe Dream” given by the lead author of the study, Lora E. Burke, PhD, a professor of nursing and epidemiology at the University of Pittsburgh in Pennsylvania, at the AHA meeting.

Given that CVD remains the leading cause of global death, and that poor risk factors remain prevalent despite the fact that 80% of CVD events are preventable through effective management of modifiable risk factors, novel tools are required for more effective management, according to Burke.

The AHA review was undertaken to look at the current evidence of the feasibility and effectiveness of mHealth approaches to reducing CVD risk. The mobile technologies used in the studies reviewed included texting/short message service (SMS), mobile applications (apps) for self-monitoring, Internet (websites and emails), interactive voice response (IVR), and wearable tracking devices.

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The study found that the use of mobile health is feasible given the rapidly advancing technology that exists, for example, with smartphones and wearable sensors that are ideal for self-monitoring and daily data collection. Burke also highlighted that these technologies are socially acceptable, ubiquitous, and transmit data/feedback remotely in real time, all of which promote engagement, which in turn promotes adherence to a goal.

The review also provided preliminary evidence on the benefit of these technologies. “There are many benefits to using mobile health to reach patients–in real time and where they are,” said Burke, adding that use of mobile health also provides ongoing contact or feedback to self-monitoring of behaviors associated with CVD and targeted for change, such as high blood pressure, unhealthful diet, and sedentary lifestyle.

Other benefits include the ability to access populations that are difficult to reach, to collect real-time data and provide immediate feedback, to deliver tailored interventions at flexible times and places, and provide ongoing contact with the patient that can reinforce motivation and behavior change.

Burke stressed the importance of these benefits, particularly given the limitations of a clinical encounter in which there is insufficient time to offer the amount of information and support needed to counsel and motivate the patient.

Given the evidence on mHealth technologies to reduce CVD risk, the biggest challenge now, according to Burke, is to conduct rigorous studies to provide a broader evidence base.