Mobile Apps to Support the Self-Management of Hypertension: Systematic Review of Effectiveness, Usability, and User Satisfaction (Preprint)

Abstract

IntroductionHypertension, in which the blood pressure (BP) in the arteries is raised, is one of the most common chronic diseases in adults. Patients can be diagnosed with hypertension when their systolic blood pressure (SBP) and/or diastolic blood pressure (DBP) is above 140/90 mm Hg respectively [1]. Hypertension has been recognised as a major risk factor for many diseases, such as renal failure, heart disease and stroke [1]. Despite the effect of lowering BP on reducing the risk of renal and cardiovascular disease, most people with hypertension poorly control their BP [2]. Therefore, it is important to encourage patients' involvement in controlling their BP.Self-management is considered as an important element of chronic care management [3]. Self-management demands an active role of patients in managing their symptoms, treatment, psychosocial and physical effects, and changing lifestyle [4][5][6]. Achieving an optimum level of self-management behaviour is difficult and requires considerable effort from patients. Mobile health technology (mHealth), defined as the use of mobile devices to deliver healthcare [7], has the potential to facilitate and optimise patients' self-management [8][9][10][11].This can be performed through integrating healthcare with everyday life by delivering and collecting health information and services in a convenient, accessible and interactive mode [12,13]. The use of the new generation of these mobile devices, including smartphone and tablets, has increased rapidly in recent years, and it is estimated that by 2018 smartphones will be used by one-third of the global population [14].Smartphones have become an important platform to deliver health to patients through health apps. The rapid growth in the use of these devices has been accompanied by a huge expansion in health and health-related behaviour applications, and more than 100,000 of these are used by millions of people [14,15]. Many health apps are targeted to support people with hypertension in their self-management by offering self-monitoring activities, reminders, tailored information, and feedback [16,17].To the best of our knowledge, despite the potential benefits of apps for people with hypertension and the increased use of these apps, a synthesis of studies on their effectiveness in this population has not been conducted. This systematic review will synthesise the existing evidence on the effectiveness of apps in lowering BP, as well as their usability and patients' satisfaction with their use. MethodA systematic review was conducted and reported in accordance with the PRISMA statement for systematic reviews [18,19]. Eligibility criteriaThe inclusion criteria were dependent on PICOS [18] as described below. PopulationThe population was people with hypertension (aged 18 years and over) and/or healthcare professionals (HCPs) supporting people with hypertension in their self-management in any care setting, without limitations on the participants' gender, age or socio-demographic characteristics. Studies about people with ch...