Welcome to The Community Guide! Let us know what you think of the website by completing this quick survey.

Cardiovascular Disease: Interactive Digital Interventions for Blood Pressure Self-Management

Tabs

What the CPSTF Found

About The Systematic Review

The CPSTF considers recently published systematic reviews to provide public health professionals and decision-makers with effective intervention options. A team of specialists in systematic review methods and in cardiovascular disease prevention research, practice, and policy selected and evaluated the following published review:

McLean G, Band R, Saunderson K, Hanlon P, Murray E, et al. Digital interventions to promote self-management in adults with hypertension: systematic review and meta-analysis. Journal of Hypertension 2016;34(4):600-12.

The review included seven randomized controlled trials (search period through 2014). The team examined each of the studies included in the systematic review and abstracted supplemental information about study, intervention, and population characteristics.

The CPSTF finding is based on results from the published review, additional information from the included studies, and expert input from team members and the CPSTF.

Context

There is no information for this section.

Summary of Results

More details about study results are available in the CPSTF Finding and Rationale Statement.

The systematic review included seven studies.

  • Among recruited patients who had high blood pressure, interventions led to the following outcomes:
    • Systolic blood pressure decreased by a mean of 3.7 mmHg (6 studies)
    • Diastolic blood pressure decreased by a mean of 2.4 mmHg (5 studies)
    • One study reported patients in the intervention group were significantly more likely to have their blood pressure under control after 24 months.

Summary of Economic Evidence

An economic review of this intervention was not conducted.

Applicability

While additional research is warranted, the CPSTF finding should be applicable to the use of interactive digital interventions in U.S. healthcare settings for adults who have high blood pressure.

Evidence Gaps

Additional research and evaluation are needed to answer the following questions and fill existing gaps in the evidence base. (What are evidence gaps?)

  • Are interventions effective in helping patients control their blood pressure over longer periods of time (1-2 years)?
  • Are these interventions effective in reducing morbidity, mortality, and health care utilization associated with hypertension?
  • What factors influence intervention effectiveness?
    • Use with or without self-measured blood pressure monitoring?
    • Use with or without additional counseling or interpersonal contact?
    • Setting (i.e. workplaces or community)?
    • Patients’ race, ethnicity, or socioeconomic status?
    • Length of time since hypertension diagnosis?
    • Level of blood pressure control at enrollment?
    • Use with novel or existing smartphone applications?

Study Characteristics

  • All of the included studies were randomized controlled trials.
  • Studies were conducted in the United States (3 studies), Canada (1 study), Finland (1 study), Korea (1 study), and Honduras and Mexico (1).
  • Patients were recruited in healthcare settings (6 studies) and workplaces (1 study).
  • Two U.S. studies included clinics that served urban, low-income communities. In one of these studies, recruited patients were primarily African-American (72%) or Hispanic (14%).
  • Evaluated interventions were of short duration (median 6 months).
  • Interventions used mobile phones (3 studies), web-based programs (3 studies), or telephones (1 study).
  • While limited information was provided about the digital content, all of the interventions included health education related to blood pressure self-management.
  • Patients interacted with digital components daily (3 studies) or weekly (3 studies); interactions were variable in the remaining study.
  • In five of the studies, digital components were part of self-measured blood pressure monitoring (SMBP) interventions.
  • Three studies offered contact or appropriate follow-up with a health professional or community health worker.

Publications

There are no Community Guide publications for this systematic review.