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  • Implementation to Increase Blood Pressure Control: What Works? (J Brettler and K. Reynolds, Section Editors)
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Effectiveness of mHealth Interventions in Improving Medication Adherence Among People with Hypertension: a Systematic Review

Abstract

Purpose of Review

This study aims to systematically review existing evidence on the effectiveness of mobile health technology (mHealth) interventions in addressing medication adherence among people with hypertension.

Recent Findings

Twenty-one studies of mHealth interventions were included in the final review after systematic searching and screening of publications from 2000 to 2017 in PubMed, Web of Science, and Embase. Key features of the mHealth interventions include high intervention intensity, multifactorial components, and patient-centered approaches with tailored content and interaction. All studies found tendencies to improvement in medication adherence, but only 12 studies reported that the improvements were statistically significant in the intervention groups compared with the control groups. Twelve studies also found that mHealth interventions were beneficial for blood pressure control. None of the studies was conducted in a low-income country.

Summary

Our systematic review found evidence that mHealth interventions improved medication adherence and blood pressure control among people with hypertension. However, most studies were small in sample size and short in study duration, and not all results were statistically significant. Future research should focus on investigating the sustainability and generalizability of mHealth interventions.

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Fig. 1

Abbreviations

BP:

Blood pressure

DBP:

Diastolic blood pressure

HTN:

Hypertension

RCT:

Randomized controlled trial

SBP:

Systolic blood pressure

SMS:

Short message services

mHealth:

Mobile Health

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Acknowledgments

We would like to thank Jingyu Tong, Mengsi Jiang, Shujun Fan, and Taylor Allen, who have provided great support during the process of developing this manuscript.

Author information

Affiliations

Authors

Contributions

SX, HB, MS, and EG drafted the manuscript. LLY raised the research question and led the study design. SX, HB, MS, WP, and AS conducted literature searching, screening, and data extraction. All authors provided critical revision of the manuscript and approved the final manuscript.

Corresponding authors

Correspondence to Enying Gong or Lijing L. Yan.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

All reported studies/experiments with human or animal subjects performed by the authors have been previously published and complied with all applicable ethical standards.

Additional information

Shangzhi Xiong, Hudson Berkhouse, and Mary Schooler are co-first authors.

This article is part of the Topical Collection on Implementation to Increase Blood Pressure Control: What Works?

Appendices

Appendix 1

Table 3 PRISMA 2009 checklist

Appendix 2. Detailed Search Algorithm (Syntax) for Pubmed

This appendix provides detailed search algorithm (syntax) for the literature search on Pubmed. Analogous algorithms were used to search Embase and Web of Science.

The overall algorithm is: #1 AND #2 AND #3 AND #4

  • #1 (hypertension[Title/Abstract] OR hypertensive[Title/Abstract] OR hyperten*[Title/Abstract] OR “high blood pressure”[Title/Abstract] OR “blood pressure”[Title/Abstract] OR “escalated blood pressure”[Title/Abstract] OR “elevated blood pressure”[Title/Abstract] OR “abnormal blood pressure”[Title/Abstract])

  • #2 (medication[Title/Abstract] OR medicine[Title/Abstract] OR medical[Title/Abstract] OR regimen[Title/Abstract] OR drug[Title/Abstract] OR prescription[Title/Abstract])

  • #3 (Adherence[Title/Abstract] OR nonadherence[Title/Abstract] OR compliance[Title/Abstract] OR persistence[Title/Abstract] OR concordance[Title/Abstract] OR consistency[Title/Abstract] OR consistent[Title/Abstract])

  • #4 (mhealth[Title/Abstract] OR m-Health[Title/Abstract] OR “mobile health”[Title/Abstract] OR “cell phone”[Title/Abstract] OR “smart phone”[Title/Abstract] OR “text message”[Title/Abstract] OR SMS[Title/Abstract] OR “short messaging service”[Title/Abstract] OR tele-medicine[Title/Abstract] OR “mobile application”[Title/Abstract] OR eHealth[Title/Abstract] OR apps[Title/Abstract] OR application[Title/Abstract])

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Xiong, S., Berkhouse, H., Schooler, M. et al. Effectiveness of mHealth Interventions in Improving Medication Adherence Among People with Hypertension: a Systematic Review. Curr Hypertens Rep 20, 86 (2018). https://doi.org/10.1007/s11906-018-0886-7

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Keywords

  • Hypertension control
  • Medication adherence
  • Mobile health
  • Systematic review