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Study suggests need for greater regulation, oversight of smartphone apps for hypertension management
Smartphone-based medical apps designed to measure BP and heart rate are popular, but a new study found that there is little regulation and a lack of validation of these apps.
Researchers conducted a cross-sectional study to evaluate 107 smartphone-based apps intended for hypertension management. The apps were collected from Google Play (50 apps) and iTunes (57 apps) using “hypertension” and “high blood pressure” as search terms, with functions that included tracking factors such as BP, weight and BMI; providing general information on hypertension; and assisting with medication adherence. The total number and value of consumer reviews were recorded, along with the total number of downloads reported for the Google Play apps.
Use, features of apps studied
Nearly all of the apps (95.3%) were intended for patient use, 2.8% were designed for physicians, and 1.9% were designed for both physicians and patients. The most common feature of the apps studied was tracking (71.9%), specifically BP (69.1%), heart rate (61.7%), weight and BMI (27.1%), calorie intake (4.6%) and sodium intake (2.8%). Two-thirds (66.3%) of the apps provided analytical tools for BP assessment and heart rate trends, and 43.9% exported patient data to physicians via email.
Thirty-seven percent of apps provided general information on hypertension, and 3.7% provided information on alternative therapies. Medication adherence tools were featured by 22.4% of the apps, included notifications or alarms (10.3%), usage logs (10.3%) and notifications to check BP (19.6%).
Smartphone as a medical device
Most of the apps were intended for health management purposes, but 14% of the apps available on Google Play allowed the smartphone to function as a medical device by measuring BP or heart rate. However, according to the researchers, none of these apps incorporated a BP cuff or indicated validation against a gold standard. All apps measured BP via a “cuffless technique” for which the user placed a finger on the screen or camera of the smartphone. The report also indicated that very few apps (3%) provided information that a health care agency was involved in the development process.
Among the Google Play apps, the ability to function as a medical device and increased number of downloads were significantly predictive of a positive review by consumers (P<.001 for both). If a tracking function was featured, more people were likely to download the app (OR=16.67; P=.015) and provide a favorable rating (IRR=16.67; P=.015), according to the researchers’ calculations after adjustment for price.
Regulation, oversight
The researchers concluded that “there is an urgent need for greater regulation and oversight in medical app development.
“High-quality, adequately powered randomized controlled trials are needed to evaluate the effectiveness of mobile-health interventions on clinical outcomes in hypertension. There is need for leading health care organizations … to adopt a greater role in the research and development of mobile health technologies.”
Disclosure: The researchers report no relevant financial disclosures.