gms | German Medical Science

Introduction: In Germany, almost two thirds of adults aged ≥65 are diagnosed with hypertension, a major risk factor for cardiovascular diseases [1]. Alongside regular blood pressure monitors, modern assistive technology (AT) can support patients in several ways. Health applications aid in disease monitoring or dietary management, wearable devices track activity levels, digital pill dispensers or electronic calendars can help manage medications, and in-house emergency buttons can be used to call for help [2], [3] The World Health Organization defined AT as “any item, piece of equipment or product […] that is used to increase, maintain or improve the functional capabilities of individuals with disability” ([4], p.14). This analysis focuses on the types of AT used by community-dwelling hypertensive adults aged ≥65.

Methods: This evaluation is part of a cross-sectional study on AT use in older adults. A paper-based, machine-readable questionnaire was sent to 2,500 adults aged ≥65. Participants were randomly selected from all residents of a mixed urban and rural county in southern Germany. A stamped return envelope was provided. Returned questionnaires were automatically recorded. An ethics vote was obtained (GEHBa-202101-V-014, 5 Feb 2021).

Results: A total of 619 people participated (response rate 24.8%). In the sample of 261 (42.2%) hypertensive patients with a mean age of 74.7 (±6.9), gender was almost distributed equally with 135 (51.7%) male and 126 (48.3%) female persons. Most had ≥3 comorbidities (n=189, 72.4%). Interest in technology was not present or little for 78 (29.9%), medium for 136 (52.1%), and high for 47 (18%). The three most frequently used AT were a landline phone (n=246, 94.3%), a blood pressure monitor (n=233, 89.3%), and a body scale (n=202, 77.4%).Considering newer AT, a wearable device was used by 37 (14.2%), an electronic calendar by 27 (10.3%), a health application by 12 (4.6%), an in-house emergency button by 7 (2.7%) persons, and a digital pill dispenser by 1 (0.4%) person.

Discussion: With the exception of a blood pressure monitor, use of specific AT assisting with hypertension among older adults is low. Use of newer devices such as wearables or health applications was low, despite almost 70% owning a smartphone. Especially health applications hold promise for personal disease management, blood pressure reduction, and medication adherence [2], [5].

The response rate of nearly 25% was higher than expected considering the absence of reminders or incentives. This could be attributed to a general interest in the topic or the impact of the Covid-19 pandemic, which led more people to stay at home with spare time on their hands.

Conclusion: The findings of this study suggest that the potential of modern AT to support management of hypertension in older adults is barely utilized. To improve adoption rates and promote the benefits of AT for hypertension management in this population, there is a need for increased awareness, education, and research. In this context, healthcare professionals may play a key role in promoting the use of AT and providing patients with appropriate guidance and support in selecting and using these devices.

The authors declare that they have no competing interests.

The authors declare that a positive ethics committee vote has been obtained.