Provider- and Patient-Related Barriers to and Facilitators of Digital Health Technology Adoption for Hypertension Management: Scoping Review
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Abstract
BACKGROUND: The uptake of digital health technology (DHT) has been surprisingly low in clinical practice. Despite showing great promise to improve patient outcomes and disease management, there is limited information on the factors that contribute to the limited adoption of DHT, particularly for hypertension management. OBJECTIVE: This scoping review provides a comprehensive summary of barriers to and facilitators of DHT adoption for hypertension management reported in the published literature with a focus on provider- and patient-related barriers and facilitators. METHODS: This review followed the methodological framework developed by Arskey and O'Malley. Systematic literature searches were conducted on PubMed or Medical Literature Analysis and Retrieval System Online, Cumulative Index to Nursing and Allied Health Literature, and Excerpta Medica database. Articles that reported on barriers to and/or facilitators of digital health adoption for hypertension management published in English between 2008 and 2017 were eligible. Studies not reporting on barriers or facilitators to DHT adoption for management of hypertension were excluded. A total of 2299 articles were identified based on the above criteria after removing duplicates, and they were assessed for eligibility. Of these, 2165 references did not meet the inclusion criteria. After assessing 134 studies in full text, 98 studies were excluded (full texts were either unavailable or studies did not fulfill the inclusion criteria), resulting in a final set of 32 articles. In addition, 4 handpicked articles were also included in the review, making it a total of 36 studies. RESULTS: A total of 36 studies were selected for data extraction after abstract and full-text screening by 2 independent reviewers. All conflicts were resolved by a third reviewer. Thematic analysis was conducted to identify major themes pertaining to barriers and facilitators of DHT from both provider and patient perspectives. The key facilitators of DHT adoption by physicians that were identified include ease of integration with clinical workflow, improvement in patient outcomes, and technology usability and technical support. Technology usability and timely technical support improved self-management and patient experience, and positive impact on patient-provider communication were most frequently reported facilitators for patients. Barriers to use of DHTs reported by physicians include lack of integration with clinical workflow, lack of validation of technology, and lack of technology usability and technical support. Finally, lack of technology usability and technical support, interference with patient-provider relationship, and lack of validation of technology were the most commonly reported barriers by patients. CONCLUSIONS: Findings suggest the settings and context in which DHTs are implemented and individuals involved in implementation influence adoption. Finally, to fully realize the potential of digitally enabled hypertension management, there is a greater need to validate these technologies to provide patients and providers with reliable and accurate information on both clinical outcomes and cost effectiveness.
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Digital health interventions risk widening health inequities if deployment favors populations with existing digital access and literacy.
“Digital health interventions risk widening health inequities if deployment favors populations with existing digital access and literacy [11,12].”
From Implementing UK Oncology Nursing Society–Informed Digital Symptom Triage With Episode-Based Review in Routine NHS Acute Oncology: Service Evaluation (2026) · cites this paper as [11]
The Results section (Barriers for Digital Health Adoption; page not provided) reports that connectivity problems and technical skills can impede patients’ use of digital health technologies, and that equipment cost is another barrier. These findings support the concern about unequal access and ability to use the tools, but the paper does not state that deployment favoring digitally equipped populations risks widening health inequities. (LLM, conf=0.82)
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- Authors
- Palacholla, R. S., Fischer, N., Coleman, A., Agboola, S., Kirley, K., Felsted, J., Katz, C., Lloyd, S., & Jethwani, K.
- Affiliations
- Harvard University (US)
- American Medical Association (US)
- Corresponding author
- Palacholla, Ramya Sita
- ORCID
- Venue
- JMIR Cardio
- Publisher
- JMIR Publications Inc.
- Published
- 2019-03-26
- Volume
- 3
- Issue
- 1
- Pages
- e11951
- ISSN
- 2561-1011 (ISSN-L)
- PMC
- PMC6834226
- OpenAlex
- W2908971590
- Cited by
- 127
- References
- 60
- Citations by year
- 2026: 15 · 2025: 22 · 2024: 23 · 2023: 32 · 2022: 13 · 2021: 15 · 2020: 5 · 2019: 2
- FWCI
- 1.61
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- JMIR Cardio (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Keywords
- digital health adoption, antihypertensive therapy, barriers to adoption, adoption facilitators, provider perspectives, patient perspectives, clinical workflow integration, technology usability, technical support, patient-provider communication, patient self-management, patient experience, technology validation, telemedicine, remote patient monitoring, mobile health apps, wearable devices, health information technology, health information exchange
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