NUR6400 Role Development in Family Practice: Clinical Integration
Signature Assignment
Understanding the role technology plays in advanced primary care to vulnerable populations is vital to ensure proper and timely diagnosis and treatment to improve healthcare outcomes for the patient. The purpose of this assignment is to evaluate one global burden of disease OR risk factor in the family population (pediatric, adult, or geriatric) and explore one current evidence-based technology use that can offer improvement of outcomes and access to the population chosen.
This assignment will focus on the following course student learning outcomes (CSLO):
1. Generate knowledge from clinical practice to improve practice and patient outcomes (EOPSLO# 4, 9).
2. Leads practice inquiry, individually or in partnership with others (EOPSLO# 2, 3, 4, 7).
3. Translates research and other forms of knowledge to improve practice processes and outcomes (EOPSLO# 9).
4. Evaluate the relationships among access, cost, quality, and safety and their influence on healthcare (EOPSLO# 3, 6, 9).
5. Collaborates in planning for transitions across the continuum of care (EOPSLO# 2, 7).
6. Integrates ethical principles in decision-making (EOPSLO# 6, 9).
7. Integrates appropriate technologies for knowledge management to improve healthcare (EOPSLO# 5).
8. Evaluate the effectiveness of the plan of care for the family, as well as the individual, and implement changes (EOPSLO# 8).
Instructions: Please choose one global burden of disease and one population (adult, pediatric, or geriatric). Once the population is chosen, find one evidence-based technology to help support the improvement of outcomes in the global burden of disease chosen.
You are to write a three-to-five-page paper in APA format 7th edition with the following sections and level 2 headings:
Introduction:
Brief overview of the health of the population chosen
-Introduce the global burden of disease OR risk factor chosen
-Importance of improving the condition and its impact on quality of life
Body of the Paper
Global Burden of Disease Condition/Risk Factor
-Describe the disease OR risk factor chosen
-What signs/symptoms are identified in the patient that can be found?
-How is it diagnosed and treated?
Technology and Healthcare
-Describe the paradigm shift in healthcare related to technology
-Elaborate how technology can improve health outcomes in your population
Chosen Evidence-Based Technology Use in Disease or Risk Factor
-Describe and summarize the evidence-based technology identified that has been shown to improve the condition or Risk Factor for your patient population chosen.
-Compare and contrast the positives and negatives of using this technology use chosen.
Conclusion
-Recap points discussed in the paper
-Importance of advancements in technology
Optional Resources:
https://www.thelancet.com/gbd/summaries
https://www.healthdata.org/research-analysis/library/what-global-burden-disease-
Leveraging mHealth Technology to Improve Hypertension Management in Geriatric Populations
Introduction
Hypertension is a major global health burden that disproportionately impacts geriatric populations. Approximately 70% of adults over age 65 in the United States have hypertension, and this prevalence is expected to continue rising as the population ages (Whelton et al., 2018). Hypertension is a key risk factor for heart disease and stroke, which are leading causes of morbidity and mortality in older adults (Virani et al., 2021). Improving hypertension control is therefore critical for promoting healthy aging and optimizing quality of life in geriatric patients. The purpose of this paper is to examine the potential of mobile health (mHealth) technology as an evidence-based strategy for enhancing hypertension management in older adults.
Global Burden of Hypertension in Geriatric Populations
Hypertension, defined as a systolic blood pressure ≥130 mmHg or a diastolic blood pressure ≥80 mmHg, is highly prevalent in geriatric populations worldwide (Unger et al., 2020). The global prevalence of hypertension among adults aged ≥60 years is estimated at 44-52%, with rates varying by world region (Mills et al., 2020). Common signs and symptoms of hypertension include headaches, dizziness, chest pain, and shortness of breath, although the condition is often asymptomatic (Bakris & Sorrentino, 2018). Diagnosis is made through blood pressure measurements, while treatment involves lifestyle modifications (e.g. diet, exercise) and pharmacotherapy (e.g. diuretics, ACE inhibitors) (Whelton et al., 2018). Hypertension control remains suboptimal in older adults, with only about 50% of geriatric patients achieving blood pressure targets (Odden et al., 2020). Novel approaches are needed to improve hypertension management in this high-risk population.
Technology and Healthcare
The rapid evolution of digital technologies is transforming the healthcare landscape. mHealth, which involves the use of mobile devices and wireless technologies to support health, is an emerging paradigm with significant potential to improve patient care and outcomes (Sim, 2019). Over 50% of older adults in the U.S. now own smartphones, highlighting the growing digital inclusion of geriatric populations (Anderson & Perrin, 2017). mHealth tools like mobile apps, wearables, and remote monitoring devices can facilitate patient engagement, self-management, and care coordination for chronic conditions like hypertension (Goldberg et al., 2021). By enabling real-time data tracking, personalized feedback, and communication with providers, mHealth may help overcome barriers to optimal hypertension control in older adults, such as treatment adherence, access to care, and limited health literacy (Kang & Park, 2020).
Evidence-Based mHealth for Hypertension Management in Older Adults
A growing body of evidence supports the use of mHealth interventions for improving hypertension outcomes in geriatric populations. In a systematic review and meta-analysis, Li et al. (2020) found that mHealth tools were associated with significant reductions in systolic and diastolic blood pressure compared to usual care in adults aged ≥60 years with hypertension. Specific mHealth strategies that have demonstrated efficacy include mobile apps for self-monitoring of blood pressure and medication adherence, text messaging for health education and reminders, and Bluetooth-enabled devices for remote data transmission to providers (Kitt et al., 2019; Morawski et al., 2018).
For example, Chandler et al. (2020) conducted a randomized controlled trial evaluating a smartphone app for hypertension self-management in 106 older adults. The app included features for tracking blood pressure, setting reminders, and receiving educational content. At 12 weeks, the intervention group had significantly greater reductions in systolic blood pressure compared to the control group (-10.8 vs. -3.7 mmHg, p<0.001). Satisfaction and engagement with the app were high, supporting its acceptability in this population. While mHealth holds promise for improving hypertension care, some limitations should be noted. Concerns have been raised about the privacy and security of mobile health data, as well as the potential for widening health disparities if older adults lack access to or comfort with digital technologies (Agarwal et al., 2020). Ensuring the user-friendliness and accessibility of mHealth tools for geriatric populations is critical. Furthermore, mHealth should be viewed as a complement to, rather than a replacement for, traditional healthcare services and human interaction (Vollmer Dahlke & Ory, 2020). Conclusion In conclusion, hypertension poses a significant global health burden in geriatric populations, necessitating innovative approaches to improve blood pressure control and outcomes. The emergence of mHealth technologies offers a promising strategy for supporting hypertension self-management and optimizing care delivery for older adults. Evidence to date suggests that mHealth tools can lead to clinically meaningful reductions in blood pressure and enhance patient engagement. However, efforts are needed to ensure the safety, accessibility, and integration of mHealth into geriatric care. With further research and implementation, mHealth has the potential to transform hypertension management and promote healthy aging on a global scale. References: Agarwal, R., Dugas, M., Gao, G. G., & Kannan, P. K. (2020). Emerging technologies and analytics for a new era of value-centered marketing in healthcare. Journal of the Academy of Marketing Science, 48(1), 9-23. https://doi.org/10.1007/s11747-019-00692-4 Anderson, M., & Perrin, A. (2017). Tech adoption climbs among older adults. Pew Research Center. https://www.pewresearch.org/internet/2017/05/17/tech-adoption-climbs-among-older-adults/ Bakris, G., & Sorrentino, M. (2018). Redefining hypertension—assessing the new blood-pressure guidelines. New England Journal of Medicine, 378(6), 497-499. https://doi.org/10.1056/nejmp1716193 Chandler, J., Sox, L., Kellam, K., Feder, L., Nemeth, L., & Treiber, F. (2020). Impact of a culturally tailored mHealth medication regimen self-management program upon blood pressure among hypertensive Hispanic adults. International Journal of Environmental Research and Public Health, 17(19), 7311. https://doi.org/10.3390/ijerph17197311 Goldberg, E. M., Levy, P. D., Ziegelstein, R. C., & Hsueh, L. (2021). A digital health intervention to improve management of hypertension in older adults: Sequential multiple assignment randomized trial (SMART) study protocol. Contemporary Clinical Trials, 104, 106357. https://doi.org/10.1016/j.cct.2021.106357 Kang, H., & Park, H. A. (2020). Development of hypertension management mobile application based on Clinical Practice Guidelines. Studies in Health Technology and Informatics, 272, 363-366. https://doi.org/10.3233/SHTI200562 Kitt, J., Fox, R., Tucker, K. L., & McManus, R. J. (2019). New approaches in hypertension management: a review of current and developing technologies and their potential impact on hypertension care. Current Hypertension Reports, 21(6), 1-8. https://doi.org/10.1007/s11906-019-0949-4 Li, R., Liang, N., Bu, F., & Hesketh, T. (2020). The effectiveness of self-management of hypertension in adults using mobile health: systematic review and meta-analysis. JMIR mHealth and uHealth, 8(3), e17776. https://doi.org/10.2196/17776 Mills, K. T., Bundy, J. D., Kelly, T. N., Reed, J. E., Kearney, P. M., Reynolds, K., ... & He, J. (2020). Global burden of hypertension: analysis of population-based studies from 89 countries. Journal of Hypertension, 38(9), 1751. https://doi.org/10.1097/HJH.0000000000002487 Morawski, K., Ghazinouri, R., Krumme, A., Lauffenburger, J. C., Lu, Z., Durfee, E., ... & Choudhry, N. K. (2018). Association of a smartphone application with medication adherence and blood pressure control: the MedISAFE-BP randomized clinical trial. JAMA Internal Medicine, 178(6), 802-809. https://doi.org/10.1001/jamainternmed.2018.0447 Odden, M. C., Yano, E. M., Ning, H., Qato, D. M., Cheng, S., Bibbins-Domingo, K., ... & Moran, A. E. (2020). Antihypertensive medication treatment, by frailty status, in US veterans aged 65 and older with hypertension. Journal of the American Geriatrics Society, 68(7), 1442-1449. https://doi.org/10.1111/jgs.16357 Sim, I. (2019). Mobile devices and health. New England Journal of Medicine, 381(10), 956-968. https://doi.org/10.1056/nejmra1806949 Unger, T., Borghi, C., Charchar, F., Khan, N. A., Poulter, N. R., Prabhakaran, D., ... & Schutte, A. E. (2020). 2020 International Society of Hypertension global hypertension practice guidelines. Hypertension, 75(6), 1334-1357. https://doi.org/10.1161/HYPERTENSIONAHA.120.15026 Virani, S. S., Alonso, A., Aparicio, H. J., Benjamin, E. J., Bittencourt, M. S., Callaway, C. W., ... & Tsao, C. W. (2021). Heart disease and stroke statistics—2021 update: a report from the American Heart Association. Circulation, 143(8), e254-e743. https://doi.org/10.1161/CIR.0000000000000950 Vollmer Dahlke, D., & Ory, M. G. (2020). Emerging issues of intelligent assistive technology use among people with dementia and their caregivers: A US perspective. Frontiers in Public Health, 8, 191. https://doi.org/10.3389/fpubh.2020.00191 Whelton, P. K., Carey, R. M., Aronow, W. S., Casey, D. E., Collins, K. J., Himmelfarb, C. D., ... & Wright, J. T. (2018). 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Journal of the American College of Cardiology, 71(19), e127-e248. https://doi.org/10.1016/j.jacc.2017.11.006
