PMID- 35014961 OWN - NLM STAT- MEDLINE DCOM- 20220201 LR - 20220317 IS - 2291-5222 (Electronic) IS - 2291-5222 (Linking) VI - 10 IP - 1 DP - 2022 Jan 11 TI - Effect of an Integrative Mobile Health Intervention in Patients With Hypertension and Diabetes: Crossover Study. PG - e27192 LID - 10.2196/27192 [doi] LID - e27192 AB - BACKGROUND: Obesity, hypertension, and type 2 diabetes mellitus (T2DM) are worldwide epidemics that inflict burdens on both public health and health care costs. Self-management plays an important role in the proper management of these 3 chronic diseases, and in this context, mobile health (mHealth) can be a cost-effective self-management tool. OBJECTIVE: The aim of this pilot study is to evaluate the effects of an integrative mHealth approach for obesity, hypertension, and T2DM on body fat, blood pressure, and blood glucose levels and demonstrate the clinical outcomes. The participants were patients aged 40 to 70 years who were treated for T2DM (hemoglobin A(1c) [HbA(1c)] above 6.0%) without insulin or hypertension and obesity, controlled with pharmacotherapy. METHODS: This pilot study was performed using a controlled, randomized, 3-month, 2-period crossover design. A total of 37 participants were recruited from 2 university hospitals in South Korea. Integrative mHealth comprised 4 parts: self-measuring home devices for monitoring blood glucose and blood pressure; 2 smartphone apps, where one gathered lifestyle data, giving them feedback with health information, and the other provided drug information and reminders of the medication schedule; unmanned kiosks for official measurement of blood pressure and body composition; and web-based access to participants' health information. RESULTS: Data from the 32 participants were analyzed. Their mean HbA(1c) level was 7.5% (SD 0.8, ranging from 6.1% to 9.4%). Approximately 38% (12/32) of the participants had hypertension. BMIs of all participants except 1 were >23 kg/m(2). The input rates of food intake and exercise to the smartphone app were very low (24.9% and 5.3%, respectively). On the contrary, the input rate of medicine intake was high (84.0%). Moreover, there was no significant difference in the input rate of taking medicine irrespective of whether the mHealth period was before or after the conventional treatment period (80.3% and 87.3%, respectively; P=.06). Among the 3 input functions of food intake, exercise, and medicine intake in smartphone apps, the input of medicine intake was a more helpful, easier to use, and better-designed function than the others. There were no significant differences in changes in body weight (-0.519 kg vs 0 kg), BMI (-0.133 kg/m(2) vs -0.167 kg/m(2)), body composition (body fat -0.255% vs 0.172%), blood pressure (systolic -0.226 mm Hg vs -2.839 mm Hg), and HbA(1c) (-0.269% vs -0.009%) between the integrative mHealth and conventional treatment groups. However, in proportion to the elevation in the input rate of taking medicine, body fat mass (P=.04) and HbA(1c) (P=.03) were lower in the integrative mHealth group. CONCLUSIONS: Although smartphone apps can influence body fat and blood glucose levels, they have failed to show clinical improvement. A higher input rate of taking medicine was related to significantly lower body fat mass and HbA(1c) levels. CI - (c)Sang Woo Oh, Kyoung-Kon Kim, Sung Soo Kim, Su Kyung Park, Sangshin Park. Originally published in JMIR mHealth and uHealth (https://mhealth.jmir.org), 11.01.2022. FAU - Oh, Sang Woo AU - Oh SW AUID- ORCID: 0000-0002-5623-6720 AD - Department of Family Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Gyeonggi-do, Republic of Korea. FAU - Kim, Kyoung-Kon AU - Kim KK AUID- ORCID: 0000-0003-0374-2571 AD - Department of Family Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea. FAU - Kim, Sung Soo AU - Kim SS AUID- ORCID: 0000-0001-9417-7728 AD - Department of Family Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Republic of Korea. FAU - Park, Su Kyung AU - Park SK AUID- ORCID: 0000-0002-0738-4786 AD - Department of Family Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Gyeonggi-do, Republic of Korea. FAU - Park, Sangshin AU - Park S AUID- ORCID: 0000-0003-2407-0962 AD - Graduate School of Urban Public Health & Department of Urban Big Data Convergence, University of Seoul, Seoul, Republic of Korea. LA - eng PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20220111 PL - Canada TA - JMIR Mhealth Uhealth JT - JMIR mHealth and uHealth JID - 101624439 SB - IM MH - Cross-Over Studies MH - *Diabetes Mellitus, Type 2/epidemiology/therapy MH - Humans MH - *Hypertension/epidemiology/therapy MH - Pilot Projects MH - *Telemedicine PMC - PMC8790692 OTO - NOTNLM OT - diabetes mellitus type 2 OT - hypertension OT - mHealth OT - mobile phone OT - obesity COIS- Conflicts of Interest: None declared. EDAT- 2022/01/12 06:00 MHDA- 2022/02/02 06:00 PMCR- 2022/01/11 CRDT- 2022/01/11 12:20 PHST- 2021/01/15 00:00 [received] PHST- 2021/11/19 00:00 [accepted] PHST- 2021/05/18 00:00 [revised] PHST- 2022/01/11 12:20 [entrez] PHST- 2022/01/12 06:00 [pubmed] PHST- 2022/02/02 06:00 [medline] PHST- 2022/01/11 00:00 [pmc-release] AID - v10i1e27192 [pii] AID - 10.2196/27192 [doi] PST - epublish SO - JMIR Mhealth Uhealth. 2022 Jan 11;10(1):e27192. doi: 10.2196/27192.