The use of an app should be considered as a useful information and communication technology innovation that can improve communication and accessibility for older people with home-based health care.

The study’s rationale The need for home care among older persons is increasing, and mHealth is evolving to help meet the challenge. When developing an app to help maintain their health, it is essential to incorporate older persons’ preferences. Aims and objectives To describe and evaluate the experiences of self‐care support and sense of security among older persons using an interactive app to report health concerns. Methodological design and justification The study had a descriptive and evaluative design. Qualitative and quantitative methods were applied to achieve a broader understanding. Ethical issues and approval Ethical approval was obtained from the Regional Ethical Review Board. The older persons received verbal and oral information about the study and gave written informed consent. Research methods Questionnaires (n = 17 older persons) answered at baseline, end of the intervention and at a 6‐month follow‐up were analysed with statistical analysis. Interviews (n = 17 older persons) conducted at the end of the intervention were analysed using a qualitative directed approach. Measurements and intervention The questionnaire included the Appraisal of Self‐care Agency Scale and a question concerning sense of security. For 3 months, the older persons used an app for regular reporting of health concerns. The app included self‐care advice, graphs and a risk assessment model that generated alerts directly to the nurses. Results The older persons described how self‐care and sense of security increased at the end of intervention, but statistically, it was shown to decrease afterwards. Study limitations The small sample size for statistical analysis. Conclusions This study shows that an app can be a complementary tool to conventional home care that can increase older persons’ sense of security and self‐care ability. The results mirror the older persons’ awareness that the support they received with the app was only temporary. Larger studies are needed for generalisation.

Background Information on how behavior change strategies have been used to design digital interventions (DIs) to improve blood pressure (BP) control or medication adherence (MA) for patients with hypertension is currently limited. Objective Hypertension is a major modifiable risk factor for cardiovascular diseases and can be controlled with appropriate medication. Many interventions that target MA to improve BP are increasingly using modern digital technologies. This systematic review was conducted to discover how DIs have been designed to improve MA and BP control among patients with hypertension in the recent 10 years. Results were mapped into a matrix of change objectives using the Intervention Mapping framework to guide future development of technologies to improve MA and BP control. Methods We included all the studies regarding DI development to improve MA or BP control for patients with hypertension published in PubMed from 2008 to 2018. All the DI components were mapped into a matrix of change objectives using the Intervention Mapping technique by eliciting the key determinant factors (from patient and health care team and system levels) and targeted patient behaviors. Results The analysis included 54 eligible studies. The determinants were considered at two levels: patient and health care team and system. The most commonly described determinants at the patient level were lack of education, lack of self-awareness, lack of self-efficacy, and forgetfulness. Clinical inertia and an inadequate health workforce were the most commonly targeted determinants at the health care team and system level. Taking medication, interactive patient-provider communication, self-measurement, and lifestyle management were the most cited patient behaviors at both levels. Most of the DIs did not include support from peers or family members, despite its reported effectiveness and the rate of social media penetration. Conclusions This review highlights the need to design a multifaceted DI that can be personalized according to patient behavior(s) that need to be changed to overcome the key determinant(s) of low adherence to medication or uncontrolled BP among patients with hypertension, considering different levels including patient and healthcare team and system involvement.