Study: Behavioral coaching app reduces hypertensive participants' blood pressure

The daily-use digital intervention yielded "clinically meaningful" improvement in blood pressure among 172 users.
By Dave Muoio
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A study published last month in JMIR Cardio demonstrated significant systolic and diastolic blood pressure reductions in hypertension patients who received a mobile app-based behavior change intervention.

The investigation examined Better Therapeutics’ candidate digital therapeutic for cardiovascular disease, a daily-use app that encourages users to set and record their progress toward individualized behavioral goals. The app is supported by a remote multidisciplinary team that looks to support healthy behavior changes, with users receiving scheduled calls from a health coach over the course of a 12-week program.

The study was sponsored by Better Therapeutics and headed up by its employees.

TOPLINE DATA

Among 172 participants with hypertension, 75 percent achieved a “clinically meaningful” improvement in blood pressure. The group was 86 percent women and the mean age in the sample was 55.

Over an average of 62.6 days of app use, the mean change in systolic and diastolic blood pressure was –11.5 mmHg and –5.9 mmHg, respectively (P < .001). These reductions were even greater among those who completed the intervention (P = .02), as well as among patients whose conditions met the cutoff for stage 2 hypertension.

By 12 weeks, 43 percent of the participants who were still tracking their blood pressure had achieved control.

In addition, the researchers noted that a proof-of-concept machine learning model trained on 427 participants to predict whether or not they would complete the full treatment was generally successful, achieving a .78 area under the receiver operating characteristic curve.

HOW IT WAS DONE

Researchers identified and recruited hypertensive adults through Facebook and employer-sponsored advertisements. These individuals were required to live in the US and own a smartphone, and received the app-based treatment at no cost upon enrollment.

All participants reported their blood pressure values and other optional measurements at will throughout the study period, and their demographics or background medical history at baseline.

WHAT’S THE HISTORY

App-based behavioral therapy apps are cropping up throughout healthcare. Although the majority of these often target mental health or general wellness (which frequently don’t provide evidence of their efficacy), others such as Noom’s mobile health coaching service have released data suggesting that a mobile app-based programs can play a role in cardiovascular health.

IN CONCLUSION

“Future research should examine the ability of treatment tailored in response to this model to further enhance outcomes. In addition, research is needed to assess the durability of outcomes following the intervention period, to identify subgroups and subgroup characteristics where the targeted intervention is most/least effective, and on the use of machine learning to predict clinical outcomes and modify treatment parameters during the course of treatment. The digital intervention should also be evaluated for its effectiveness in treating other chronic diseases that share the same root causes as hypertension,” the researchers concluded.

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