Sociodemographic Characteristics Predicting Digital Health Intervention Use After Acute Myocardial Infarction

Lochan M Shah, Jie Ding, Erin M Spaulding, William E Yang, Matthias A Lee, Ryan Demo, Francoise A Marvel, Seth S Martin, Lochan M Shah, Jie Ding, Erin M Spaulding, William E Yang, Matthias A Lee, Ryan Demo, Francoise A Marvel, Seth S Martin

Abstract

Increasing evidence suggests that digital health interventions (DHIs) are an effective tool to reduce hospital readmissions by improving adherence to guideline-directed therapy. We investigated whether sociodemographic characteristics influence use of a DHI targeting 30-day readmission reduction after acute myocardial infarction (AMI). Covariates included age, sex, race, native versus loaner iPhone, access to a Bluetooth-enabled blood pressure monitor, and disease severity as marked by treatment with CABG. Age, sex, and race were not significantly associated with DHI use before or after covariate adjustment (fully adjusted OR 0.98 (95%CI: 0.95-1.01), 0.6 (95%CI: 0.29-1.25), and 1.22 (95% CI: 0.60-2.48), respectively). Being married was associated with high DHI use (OR 2.12; 95% CI 1.02-4.39). Our findings suggest that DHIs may have a role in achieving equity in cardiovascular health given similar use by age, sex, and race. The presence of a spouse, perhaps a proxy for enhanced caregiver support, may encourage DHI use.

Keywords: Digital health; Health disparities; Hospital readmission; Myocardial infarction; Sociodemographic factors; mHealth.

Conflict of interest statement

Corrie Health, as described in this work, was developed by F.A.M., M.A.L., and S.S.M. FAM, MAL, and SSM are founders of and hold equity in Corrie Health, which intends to further develop the digital platform. This arrangement has been reviewed and approved by the Johns Hopkins University in accordance with its conflict of interest policies. SSM has served as a consultant to Akcea, Amgen, AstraZeneca, DalCor Pharmaceuticals, Esperion, Kaneka, Novo Nordisk, Quest Diagnostics, Regeneron, REGENXBIO, Sanofi, and 89bio. He is a co-inventor on a system to estimate LDL cholesterol levels, patent application pending. All other authors have no relevant relationships to disclose.

© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC part of Springer Nature.

Figures

Fig. 1
Fig. 1
Screening and enrollment of study participants
Fig. 2
Fig. 2
Medication feature (n = 130) and vital signs feature (n = 121) use over 30 days post-discharge

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