Effectiveness, reach, uptake, and feasibility of digital health interventions for adults with hypertension: a systematic review and meta-analysis of randomised controlled trials

StatusVoR
Simple item page
cris.lastimport.scopus2025-06-26T03:11:53Z
dc.abstract.enBackground Digital health interventions are effective for hypertension self-management, but a comparison of the effectiveness and implementation of the different modes of interventions is not currently available. This study aimed to compare the effectiveness of SMS, smartphone application, and website interventions on improving blood pressure in adults with hypertension, and to report on their reach, uptake, and feasibility. Methods In this systematic review and meta-analysis we searched CINAHL Complete, Cochrane Central Register of Controlled Trials, Ovid Embase, Ovid MEDLINE, and APA PsycInfo on May 25, 2022, for randomised controlled trials (RCTs) published in English from Jan 1, 2009, that examined the effectiveness of digital health interventions on reducing blood pressure in adults with hypertension. Screening was carried out using Covidence, and data were extracted following Cochrane's guidelines. The primary endpoint was change in the mean of systolic blood pressure. Risk of bias was assessed with Cochrane Risk of Bias 2. Data on systolic and diastolic blood pressure reduction were synthesised in a meta-analysis, and data on reach, uptake and feasibility were summarised narratively. Grading of Recommendations, Assessment, Development, and Evaluation criteria were used to evaluate the level of evidence. The study was registered with PROSPERO CRD42021247845. Findings Of the 3235 records identified, 29 RCTs from 13 regions (n=7592 participants) were included in the systematic review, and 28 of these RCTs (n=7092 participants) were included in the meta-analysis. 11 studies used SMS as the primary mode of delivery of the digital health intervention, 13 used smartphone applications, and five used websites. Overall, digital health intervention group participants had a –3·62 mm Hg (95% CI –5·22 to –2·02) greater reduction in systolic blood pressure, and a –2·45 mm Hg (–3·83 to –1·07) greater reduction in diastolic blood pressure, compared with control group participants. No statistically significant differences between the three different modes of delivery were observed for both the systolic (p=0·73) and the diastolic blood pressure (p=0·80) outcomes. Smartphone application interventions had a statistically significant reduction in diastolic blood pressure (–2·45 mm Hg [–4·15 to –0·74]); however, there were no statistically significant reductions for SMS interventions (–1·80 mm Hg [–4·60 to 1·00]) or website interventions (–3·43 mm Hg [–7·24 to 0·38]). Due to the considerable heterogeneity between included studies and the high risk of bias in some, the level of evidence was assigned a low overall score. Interventions were more effective among people with greater severity of hypertension at baseline. SMS interventions reported higher reach and smartphone application studies reported higher uptake, but differences were not statistically significant. Interpretation SMS, smartphone application, and website interventions were associated with statistically and clinically significant systolic and diastolic blood pressure reductions, compared with usual care, regardless of the mode of delivery of the intervention. This conclusion is tempered by the considerable heterogeneity of included studies and the high risk of bias in most. Future studies need to describe in detail the mediators and moderators of the effectiveness and implementation of these interventions, to both further improve their effectiveness as well as increase their reach, uptake, and feasibility. Funding European Union's Horizon 2020 Research and Innovation Programme.
dc.affiliationInstytut Psychologii
dc.contributor.authorSiopis, George
dc.contributor.authorMoschonis, George
dc.contributor.authorEweka, Evette
dc.contributor.authorJung, Jenny
dc.contributor.authorKwaśnicka, Dominika
dc.contributor.authorYeboah-Asiamah Asare, Bernard
dc.contributor.authorKodithuwakku, Vimarsha
dc.contributor.authorWillems, Ruben
dc.contributor.authorVerhaeghe, Nick
dc.contributor.authorAnnemans, Lieven
dc.contributor.authorVedanthan, Rajesh
dc.contributor.authorOldenburg, Brian
dc.contributor.authorManios, Yannis
dc.contributor.authorGong, Enying
dc.contributor.authorVotis, Konstantinos
dc.contributor.authorSegkouli, Sofia
dc.contributor.authorTriantafyllidis, Andreas
dc.contributor.authorKyparissis, Odysseas
dc.contributor.authorPaliokas, Ioannis
dc.contributor.authorPolychroniou, Eleftheria
dc.contributor.authorDe Craemer, Dirk
dc.contributor.authorAnastasiou, Kostas
dc.contributor.authorTserpes, Konstantinos
dc.contributor.authorMavrogianni, Christina
dc.contributor.authorKaraglani, Eva
dc.contributor.authorKalogerakou, Electra
dc.contributor.authorMaragkoudaki, Maria
dc.contributor.authorNtzouvani, Agathi
dc.contributor.authorKontochristopoulou, Katerina
dc.contributor.authorDupont, Sabine
dc.contributor.authorDupont, Elizabeth
dc.contributor.authorDauzon, Leo
dc.contributor.authorRoskams, Maartje
dc.contributor.authorLennox-Chhugani, Niamh
dc.contributor.authorPerrin, Martin
dc.contributor.authorDaly Day, Niamh
dc.contributor.authorFerrer, Georgina
dc.contributor.authorSnook, Orla
dc.contributor.authorAldasoro, Edelweiss
dc.contributor.authorGil-Salmerón, Alejandro
dc.contributor.authorGangas Peiró, Pilar
dc.contributor.authorCurran, Darren
dc.contributor.authorLyne, Fiona
dc.contributor.authorCurreri, Nereide A.
dc.contributor.authorPierantozzi, Nazzareno
dc.contributor.authorD'Antonio, Claudia
dc.contributor.authorVespasiani, Giacomo
dc.contributor.authorAlmonti, Teresa
dc.contributor.authorSkouteris, Helen
dc.contributor.authorTaylor, Tracy
dc.contributor.authorSavaglio, Melissa
dc.contributor.authorMakrilakis, Konstantinos
dc.contributor.authorStergiou, George
dc.contributor.authorLiatis, Stavros
dc.contributor.authorKaramanakos, George
dc.contributor.authorKoliaki, Chrysi
dc.contributor.authorKollias, Anastasios
dc.contributor.authorZikou, Eva
dc.contributor.authorDimosthenopoulos, Haris
dc.contributor.authorHuang, Keng-Yen
dc.contributor.authorAdhikari, Samrachana
dc.contributor.authorQian, Kun
dc.contributor.authorDickhaus, Julia
dc.contributor.authorCarney, Kimberly
dc.contributor.authorSahito, Farhan
dc.contributor.authorPavlovic, Dusan
dc.contributor.authorDjokic, Djordje
dc.contributor.authorSahito, Arzoo
dc.contributor.authorBattalova, Gisella
dc.contributor.authorSeghieri, Chiara
dc.contributor.authorNutti, Sabina
dc.contributor.authorVanieri, Milena
dc.contributor.authorBelle, Nicola
dc.contributor.authorBertarelli, Gaia
dc.contributor.authorCantarelli, Paola
dc.contributor.authorFerre, Francesca
dc.contributor.authorNoci, Anna
dc.contributor.authorTortu, Constanza
dc.contributor.authorBozzi, Nadia
dc.contributor.authorFerrari, Dina
dc.contributor.authorBorelli, Rachele
dc.contributor.authorIotova, Violeta
dc.contributor.authorYotov, Yoto
dc.contributor.authorUsheva, Natalia
dc.contributor.authorKozhuharova, Anna
dc.contributor.authorRusseva, Vanya
dc.contributor.authorMarinova, Vanya
dc.contributor.authorKoleva, Sonya
dc.contributor.authorAtanasova, Virginia
dc.contributor.authorStefanova, Tanya
dc.contributor.authorTsochev, Kaloyan
dc.contributor.authorMoreno Aznar, Luis
dc.contributor.authorMagallón Botaya, Rosa
dc.contributor.authorBueno Lozano, Gloria
dc.contributor.authorDe Miguel-Etayo, Pilar
dc.contributor.authorMa Gonzalez-Gil, Esther
dc.contributor.authorMiguel-Berges, María L.
dc.contributor.authorPérez, Susana
dc.contributor.authorOliván Blázquez, Bárbara
dc.contributor.authorGiménez-Legarre, Natalia
dc.contributor.authorToti, Florian
dc.contributor.authorPrifti, Skerdi
dc.contributor.authorBombaj, Blerina
dc.contributor.authorDoracaj, Ditila
dc.contributor.authorLaze, Ornela
dc.contributor.authorLapardhaja, Adriana
dc.contributor.authorBruka, Luftime
dc.date.access2023-03
dc.date.accessioned2023-10-19T10:02:41Z
dc.date.available2023-10-19T10:02:41Z
dc.date.created2023-03-01
dc.date.issued2023-03
dc.description.accesstimeat_publication
dc.description.issue3
dc.description.physical144-159
dc.description.versionfinal_published
dc.description.volume5
dc.identifier.doi10.1016/S2589-7500(23)00002-X
dc.identifier.issn2589-7500
dc.identifier.urihttps://share.swps.edu.pl/handle/swps/88
dc.identifier.weblinkhttps://www.thelancet.com/journals/landig/article/PIIS2589-7500(23)00002-X/fulltext
dc.languageen
dc.pbn.affiliationpsychologia
dc.rightsCC-BY
dc.rights.questionYes_rights
dc.share.articleOPEN_JOURNAL
dc.swps.sciencecloudsend
dc.titleEffectiveness, reach, uptake, and feasibility of digital health interventions for adults with hypertension: a systematic review and meta-analysis of randomised controlled trials
dc.title.journalThe Lancet Digital Health
dc.typeJournalArticle
dspace.entity.typeArticle