Combining Wireless Technology and Behavioral Economics to Engage Patients (WiBEEP) with cardiometabolic disease: a pilot study.

BACKGROUND

The long-term management of cardiometabolic diseases, such as type 2 diabetes and hypertension, is complex and can be facilitated by supporting patient-directed behavioral changes. The concurrent application of wireless technology and personalized text messages (PTMs) based on behavioral economics in managing cardiometabolic diseases, although promising, has not been studied. The aim of this pilot study was to evaluate the feasibility and acceptability of the concurrent application of wireless home blood pressure (BP) monitoring (as an example of "automated hovering") and PTMs (as an example of "nudging") targeting pharmacotherapy and lifestyle habits in patients with cardiometabolic disease (type 2 diabetes and/or hypertension).

METHODS

The Wireless Technology and Behavioral Economics to Engage Patients (WiBEEP) with cardiometabolic disease study was a single-arm, open-label, 7-week-long pilot study in 12 patients (mean age 58.5 years) with access to a mobile phone. The study took place at Tufts Medical Center (Boston, MA) between March and September 2017. All patients received PTMs; nine patients received wireless home BP monitoring. At baseline, patients completed questionnaires to learn about their health goals and to assess medication adherence; at the end of week 7, all patients completed questionnaires to evaluate the feasibility and acceptability of the intervention and assess medication adherence. Hemoglobin A1c was ascertained from data collected during routine clinical care in 7 patients with available data.

RESULTS

The majority of patients reported the text messages to be easy to understand (88%) and appropriate in frequency (71%) and language (88%). All patients reported BP monitoring to be useful. Mean arterial pressure was lower at the end-of-study compared to baseline (- 3.4 mmHg [95% CI, - 5 to - 1.8]. Mean change in hemoglobin A1c was - 0.31% [95% CI, - 0.56 to - 0.06].

CONCLUSIONS

Among patients with cardiometabolic disease, the combination of wireless BP monitoring and lifestyle-focused text messaging was feasible and acceptable. Larger studies will determine the long-term effectiveness of such an approach.

Déclaration de conflit d'intérêts

Ethical approval was granted by the Tufts IRB and all participants provided written informed consent.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.