Helpful technology for older patients

Dr Levine is a Practice Director, CCRM New York, and Attending Physician, Lenox Hil Hospital, New York. He has no conflict of interest to report in respect to the content of this article.

A 2015 review of smartphone ownership found that nearly two-thirds of American adults (64%) owned a smartphone of some kind, up from 58% in early 2014 (54% for those aged 50–64 and 27% for those aged 65 and older).¹ As our aging population continues to adopt smartphones, it’s important to educate our older patients about how they can use their devices to improve their health. Here I discuss a number of apps and devices geared toward helping perimenopausal and postmenopausal patients.

Apple Health

In my January 2015 article, “Top apps for ob/gyns and their patients in 2015,” I discussed the strength and utility of Apple Health, "an easy-to-use and easy-to-navigate repository of health information."² Whenever a patient asks for a health app recommendation I still name Apple Health first since it is already downloaded and installed on every current iPhone. I always make a point of reminding patients to update their *MedicalID, which is contained within Apple Health. The *MedicalID is designed to be a patient demographic snapshot including information about allergies and reactions, spouse contact information, blood type, organ donor status, and medications. *MedicalID is accessible from the lock screen on all current iPhones even if the device is locked with a password, and all first responders and hospitals know to go to *MedicalID in the event that a Jane Doe is brought to the hospital. Apple Health also has a built-in pedometer and can offer a dashboard of health data from other associated apps.

Pericoach

The PeriCoach System is an FDA-cleared home Kegel exerciser device and app that guides women in strengthening pelvic floor muscles to help treat mild, moderate, stress, and urge urinary incontinence. Beyond the impact of incontinence on daily functioning, pelvic floor disorders may contribute to low libido, blunted sexual arousal, and inability to achieve orgasm.³ This easy-to-use device is simply inserted into the vagina and the app takes the user through a series of exercises in which the user squeezes and relaxes against the PeriCoach. The strength and duration of the contractions are detected on the smartphone app through Bluetooth connectivity. These data are logged on both the smartphone app and the user portal to show progress over time. The data can easily be printed and scanned into the electronic health record.

Image courtesy of PeriCoach

Image courtesy of Withings

Withings Pulse O₂

At the end of 2015 we discussed a number of gadgets and apps that can be used for health tracking.⁴ One of those devices, which is still one of my favorites, is the Withings Smart Body Analyzer. Withings is a company that is completely focused on tracking, and their newest device, the Pulse O₂, is now on my favorite list as well. The Pulse O₂ is probably the most versatile and easy-to-use fitness tracker that I have used, which is why it is perfect for the older population. Once paired to a smartphone, the device is capable of measuring steps, elevation, and distance, and can calculate/estimate burned calories and measure sleep quality. What sets this device apart from all the others is that it can be worn on the wrist, clipped to clothing, or simply carried in a pocket or purse. Beyond its long battery life and ease of use, it also is the first device that I've used that can simply and reliably measure heart rate and pulse oximetry, 2 cardiovascular parameters that are incredibly important for our patients as we recommend 30 minutes of daily vigorous exercise. This little device is easy to adopt and easy to prescribe.

Pillboxie & Medisafe Pill Reminder

Unfortunately, a direct correlation exists between age and the number of prescribed daily medications and vitamins/supplements. Since our older patients are leading busy full lives, remembering to take these pills can be the greatest challenge of the day. Thankfully, there are apps that are dedicated to helping our patients take pills when they need them. Pillboxie is a whimsical iOS app that lets patients visually manage their medications. Users simply drop a virtual pill into the on-screen pillbox to schedule medication reminders. The app is completely customizable with a bounty of medication types and colors. Most importantly, the reminder sounds are unobtrusive but noticeable, helping patients take their medications at the appropriate time.

For patients who are more tech-savvy, I tend to recommend Medisafe Pill Reminder since it integrates with Apple Health, generates medication compliance reports, and allows for refill reminders and logging of PRN (on demand) medications. This app is wonderful for patients with acute or chronic conditions who need to keep complex regimens straight.

EyeReader

An unfortunate part of getting older is a decline in the ability to read in low light. Thankfully, there are apps to help us make it through a menu without asking the maître d' to turn up the lights. EyeReader is a simple iPhone app that uses the phone’s LED light (flash) and camera. The user simply places 2 fingers on the screen and then separates them to magnify the text. Dark, small menus suddenly become legible! This has been one of my go-to apps for senior patients for a long time because of my concern that many pill bottles look the same and patients frequently do not check the labels before taking their medications because they have a routine to their medication regimen.

As we all know, our population is aging, and our aging patients are an important part of our practice. We need to stay abreast of helpful technology because although our patients are getting older, they are getting technologically wiser. Thankfully there are devices and apps that geared to not only help our patients maintain their independence, but also to help prevent untoward outcomes.

References

1. Smith A. US Smartphone Use in 2015. Pew Research Center. http://www.pewinternet.org/2015/04/01/chapter-one-a-portrait-of-smartphone-ownership/

2. Levine BA, Goldschlag D. Top apps for ob/gyns and their patients in 2015. Contemporary OB/GYN. 2015:60(1):12–14.

3. Handa VL, Cundiff G, Chang H, Helzlsouer KJ. Female sexual function and pelvic floor disorders, Obstet Gynecol. 2008:111(5):1045–1052.

4. Levine BA. Gadgets for health tracking. Contemporary OB/GYN. 2015: http://contemporaryobgyn.modernmedicine.com/contemporary-obgyn/news/digital-obgyn-gadgets-health-tracking.