Shannon Doocy|Kenneth E. Paik|Emily Lyles|Hok Hei Tam|Zeina Fahed|Eric Winkler|Kaisa Kontunen|Abdalla Mkanna|Gilbert Burnham
Guidelines and mHealth to Improve Quality of Hypertension and Type 2 Diabetes Care for Vulnerable Populations in Lebanon: Longitudinal Cohort Study
Johns Hopkins University|Massachusetts Institute of Technology|Johns Hopkins University|Massachusetts Institute of Technology|Massachusetts Institute of Technology|Johns Hopkins University
given protracted nature crisis syria large noncommunicable disease ncd caseload syrian refugees host lebanese high costs providing ncd care implications lebanons health system vastthe aim study evaluate effectiveness treatment guidelines mobile health mhealth app quality care health outcomes primary care settings lebanona longitudinal cohort study implemented january 2015 august 2016 evaluate effectiveness treatment guidelines mhealth app quality care health outcomes syrian lebanese patients lebanese primary health care phc facilitiescompared baseline record extraction recording blood pressure bp readings 114 p001 blood sugar measurements 69 p03 significantly decreased following implementation treatment guidelines recording bp readings also decreased mhealth phase compared baseline 84 p001 however recording body mass index bmi reporting increased end mhealth phase baseline 81 p001 guidelines phase 77 p001 great proportion patients blood sugar bp weight height bmi recorded using tablet compared paper records however differences bmi statistically significant 316 higher app data compared paper records p001 data extracted mhealth app showed higher proportion providers offered lifestyle counseling compared counseling reported patients paper records health diet counseling 773 app data vs 88 paper records p001 physical activity counseling 597 app vs 71 paper records p001 statistically significant increases four measures patientprovider interaction across study phases provider inquiry medical history increased 166 baseline following guideline implementation 282 baseline mhealth implementation p001 baseline patient report provider inquiry regarding medication complications increased guidelines mhealth phases 129 596 respectively p001 proportion patients reporting providers asked questions relevant illness increased baseline guidelines implementation 278 mhealth implementation 663 p001 followup scheduling increased baseline guidelines phase 206 mhealth phase 398 p001results study mhealth app 10 phc facilities lebanon indicate app potential improve adherence guidelines quality care studies necessary determine effects patientcontrolled health record apps provider adherence treatment guidelines well patients longterm medication treatment adherence disease control