A mobile-phone Tele-medicine system that promotes self-management of blood pressure among hypertensive patients in Kirinyaga sub-county
Mugoh, James W
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Hypertension, also known as high or raised BP, is a condition in which the blood vessels have persistently raised pressure. If left uncontrolled, hypertension can lead to a heart attack, an enlargement of the heart and eventually heart failure. The pressure in the blood vessels can cause blood to leak out into the brain and cause a stroke. By realizing the devastating consequences and effects of elevated BP levels, it is therefore important to emphasize on the prevention and systematic observation to fight against this disease. Through recording and quality management of BP by the patient will provide valuable information to the medical specialists. On the other hand the doctor can monitor the short-term and long-term course of the disease, develop a complete treatment procedure and assess in detail the performance of a specific medication. The current practice adopted by hypertensive patients in managing and monitoring hypertension is making frequent visits to a health center as recommended by medical specialists. However, very few patients adhere to this practice as it is time consuming and tiresome especially if they have to travel for long distances to have their BP checked. This practice is also not feasible for critically-ill patients. Consequently, most patients neglect BP check-ups and therefore focus on medication alone. This puts the patient’s at risk as uncontrolled BP can lead to fatal complications. The overall objective of this research was to design, develop and pilot-test a mobile telemedicine system that helps patients’ to self-manage their BP condition from the comfort of their homes. Participatory action research design was used in this study. Purposeful sampling technique was used for the recruitment of participants. Testing for usability, utility and performance of the tele-medicine system was conducted. In order to collect reliable and valid information for usability and utility, patients and medical specialist were actively engaged using the E-Delphi method. The system has proved to be usable and useful in helping patients achieve better control of their BP. Performance metrics namely Uptime, Downtime, MTBF, Reliability, Response time and Availability were evaluated. The results showed that the system achieved an Uptime of 98.46%, Downtime of 0.37 %, MTBF of 9.85,Reliability of 0.9, Average Response Time of 4 seconds, and overall availability of 99.82 % during the 5-days testing period. Through self-management, a number of patients experienced some improvement in their BP. However due to limitation of testing period this fact cannot be substantially quantified .Nevertheless the results of this study are quite encouraging and a long-term trial is therefore recommended.