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Digital interventions to promote self-management in adults with hypertension systematic review and meta-analysis
Open accessAbstract
OBJECTIVE: To synthesize the evidence for using interactive digital interventions (IDIs) to support patient self-management of hypertension, and to determine their impact on control and reduction of blood pressure. METHOD: Systematic review with meta-analysis was undertaken with a search performed in MEDLINE, EMBASE, CINAHL, PsycINFO, ERIC, Cochrane Library, DoPHER, TROPHI, Social Science Citation Index and Science Citation Index. The population was adults (>18 years) with hypertension, intervention was an IDI and the comparator was usual care. Primary outcomes were change in SBP and DBP. Only randomized controlled trials and studies published in journals and in English were eligible. Eligible IDIs included interventions accessed through a computer, smartphone or other hand-held device. RESULTS: Four out of seven studies showed a significantly greater reduction for intervention compared to usual care for SBP, with no difference found for three. Overall, IDIs significantly reduced SBP, with the weighted mean difference being -3.74 mmHg [95% confidence interval (CI) -2.19 to -2.58] with no heterogeneity observed (I-squared = 0.0%, P = 0.990). For DBP, four out of six studies indicated a greater reduction for intervention compared to controls, with no difference found for two. For DBP, a significant reduction of -2.37 mmHg (95% CI -0.40 to -4.35) was found, but considerable heterogeneity was noted (I-squared = 80.1%, P = <0.001). CONCLUSION: IDIs lower both SBP and DBP compared to usual care. Results suggest these findings can be applied to a wide range of healthcare systems and populations. However, sustainability and long-term clinical effectiveness of these interventions remain uncertain.
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“Current evidence on digital health interventions is disproportionately concerned with high-income countries and hospital settings.”
From Digital health interventions for non-communicable disease management in primary health care in low-and middle-income countries (2023) · cites this paper as [19]
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“improve outcomes in people with long term conditions 7 such as cardiovascular disease (McClean in press), diabetes 8 and mental health conditions 9”
From Evaluating Digital Health Interventions (2016) · cites this paper as [7]
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“However, most of these original studies and reviews focused on high-income countries, hospital settings, or fields other than NCDs15,16,19–22.”
From Digital health interventions for non-communicable disease management in primary health care in low-and middle-income countries (2023) · cites this paper as [19]
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“Nevertheless, the long-term sustainable effects of digital health on behavioral changes remains uncertain19,20,84.”
From Digital health interventions for non-communicable disease management in primary health care in low-and middle-income countries (2023) · cites this paper as [19]
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“This disagreement may result from differences in study locations (high-income countries or LMICs), populations (general population or less advantaged populations), and study settings (hospitals or primary health care)19,20.”
From Digital health interventions for non-communicable disease management in primary health care in low-and middle-income countries (2023) · cites this paper as [19]
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“This mixture of findings on clinical outcomes added to the conflicting evidence in the existing literature, where many meta-analyses of related topics disagreed on outcomes such as blood pressure reduction19,20.”
From Digital health interventions for non-communicable disease management in primary health care in low-and middle-income countries (2023) · cites this paper as [19]
In the citing paper
“the included studies still presented high heterogeneity in the outcomes of using digital health, which was also found in other systematic reviews19–21.”
From Digital health interventions for non-communicable disease management in primary health care in low-and middle-income countries (2023) · cites this paper as [19]
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Metadata
- Authors
- McLean, G., Band, R., Saunderson, K., Hanlon, P., Murray, E., Little, P., McManus, R. J., Yardley, L., & Mair, F. S.
- Affiliations
- University of Oxford (GB)
- Corresponding author
- McLean, Gary
- ORCID
- Venue
- Journal of Hypertension
- Published
- 2016-04
- Volume
- 34
- Issue
- 4
- Pages
- 600-612
- ISSN
- 0263-6352 (ISSN-L)
- PMC
- PMC4947544
- OpenAlex
- W2321682528
- Cited by
- 168
- References
- 44
- Citations by year
- 2026: 3 · 2025: 17 · 2024: 20 · 2023: 21 · 2022: 17 · 2021: 26 · 2020: 22 · 2019: 12 · 2018: 21 · 2017: 5 · 2016: 4
- FWCI
- 2.67
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc-nd
- Locations
- Journal of Hypertension (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (acceptedVersion)
- ePrints Soton (University of Southampton) (acceptedVersion)
- Bristol Research (University of Bristol) (submittedVersion, cc-by-nc-nd)
- Funders
- National Institute for Health and Care Research (CDF/01/017, RP-PG-1211-20001)
- Economic and Social Research Council (ES/F029624/1)
- Programme Grants for Applied Research (RP-PG-1211-20001)
- Topics
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Keywords
- hypertension, self-management, mobile health, blood pressure control, systolic blood pressure, diastolic blood pressure, mobile application, patient education
- MeSH terms
- Aged, Female, Health Promotion, Humans, Hypertension, Male, Middle Aged, Self Care, Internet
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