Mobile health technology can be beneficial in encouraging lifestyle behavior changes and medication adherence among adults ages 60 and older with existing heart disease, yet more research is needed to determine what methods are the most effective, according to a new scientific statement from the American Heart Association.
Mobile health technology – the use of mobile and wireless technologies to support the achievement of health objectives – can include voice and short messaging services (text messaging), global positioning systems (GPS) and/or Bluetooth technology, as well as wearable devices that can monitor and inform the user about specific health measures or behaviors to improve health.
“Over the last decade, mobile health technology, especially the wearable technology and mobile health application markets, has grown substantially,” said the chair of the statement writing committee Erica N. Schorr, Ph.D., B.S.B.A, R.N., FAHA, an associate professor in the Adult and Gerontological Health Cooperative at the University of Minnesota School of Nursing. “There is, however, a common misperception that mobile health technology use is lower among older adults, when in fact most Americans aged 60 years and older own a cell phone and spend a significant amount of leisure time in front of a screen. This statement highlights the potential benefits that mobile health interventions can provide for monitoring, prompting, encouraging, and educating older adults with cardiovascular disease.”
An estimated two-thirds of all people with heart disease are 60 years old and over, and the prevalence of physical activity declines with aging, particularly in people who have heart disease. People who have experienced a major cardiac event, such as a heart attack or stroke, are at 20 times the risk for future cardiac events compared to people without heart disease. More research is needed to identify strategies to slow the progression of heart disease – secondary prevention strategies – in this population.
The scientific statement highlights research from 26 studies from the past 11 years that examined mobile health technology for secondary heart disease prevention in adults ages 60 and older with existing heart disease.
Studies that incorporated text messaging and website resource information showed improvements in people’s physical activity and other lifestyle behavioral changes after three months of enrollment and led to an increase in medication adherence among study participants. Significant improvements in medication adherence have also been noted in some trials when study participants used a mobile app or received a text messaging reminder. A large systematic review showed that successful mobile health interventions include frequent, personalized, two-way messaging.
“We know that controlling blood pressure, blood sugar, and cholesterol are essential secondary prevention strategies and often require medication management,” added Schorr. “Reducing sedentary time, increasing physical activity, maintaining an optimal body weight, and adopting a healthy diet are other significant lifestyle strategies to optimize the health of individuals with cardiovascular disease. Wearable devices and mobile devices, and applications play an important role because they can assist individuals in monitoring and tracking health behaviors and heart disease risk factors, referred to as the AHA’s Life’s Simple 7, to reduce their risk of a cardiac event and achieve ideal cardiovascular health.”
Schorr added there are still important questions to answer about which mobile health interventions and technology would be most effective and accepted, and how best to use them to see clinically meaningful changes in secondary cardiovascular prevention in older adults. “Answering these questions is critical to identify and implement effective, widely accepted, cost-effective, and time-efficient mobile interventions that improve health outcomes for older adults,” she said.
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