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For: Chen B, Dou Y, Yu X, Ma D. Influence of Internet-Based Health Management on Control of Clinical Parameters in Patients With Hypertension: Four-Year Longitudinal Study. J Med Internet Res 2023;25:e42896. [PMID: 36939826 PMCID: PMC10131880 DOI: 10.2196/42896] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 12/22/2022] [Accepted: 02/24/2023] [Indexed: 03/21/2023] Open

For:	Chen B, Dou Y, Yu X, Ma D. Influence of Internet-Based Health Management on Control of Clinical Parameters in Patients With Hypertension: Four-Year Longitudinal Study. J Med Internet Res 2023;25:e42896. [PMID: 36939826 PMCID: PMC10131880 DOI: 10.2196/42896] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 12/22/2022] [Accepted: 02/24/2023] [Indexed: 03/21/2023] Open

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Cited by Other Article(s)

Arshed M, Mahmud A, Minhat HS, Lim PY, Zakar R. Effectiveness of a Multifaceted Mobile Health Intervention (Multi-Aid-Package) in Medication Adherence and Treatment Outcomes Among Patients With Hypertension in a Low- to Middle-Income Country: Randomized Controlled Trial. JMIR Mhealth Uhealth 2024;12:e50248. [PMID: 38896837 PMCID: PMC11222770 DOI: 10.2196/50248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 01/31/2024] [Accepted: 04/30/2024] [Indexed: 06/21/2024] Open

Abstract

BACKGROUND

The high prevalence of uncontrolled hypertension in Pakistan is predominantly attributed to poor medication adherence. As more than 137 million people in Pakistan use cell phones, a suitable mobile health (mHealth) intervention can be an effective tool to overcome poor medication adherence.

OBJECTIVE

We sought to determine whether a novel mHealth intervention is useful in enhancing antihypertensive therapy adherence and treatment outcomes among patients with hypertension in a low- to middle-income country.

METHODS

A 6-month parallel, single-blinded, superiority randomized controlled trial recruited 439 patients with hypertension with poor adherence to antihypertensive therapy and access to smartphones. An innovative, multifaceted mHealth intervention (Multi-Aid-Package), based on the Health Belief Model and containing reminders (written, audio, visual), infographics, video clips, educational content, and 24/7 individual support, was developed for the intervention group; the control group received standard care. The primary outcome was self-reported medication adherence measured using the Self-Efficacy for Appropriate Medication Adherence Scale (SEAMS) and pill counting; the secondary outcome was systolic blood pressure (SBP) change. Both outcomes were evaluated at baseline and 6 months. Technology acceptance feedback was also assessed at the end of the study. A generalized estimating equation was used to control the covariates associated with the probability of affecting adherence to antihypertensive medication.

RESULTS

Of 439 participants, 423 (96.4%) completed the study. At 6 months post intervention, the median SEAMS score was statistically significantly higher in the intervention group compared to the controls (median 32, IQR 11 vs median 21, IQR 6; U=10,490, P<.001). Within the intervention group, there was an increase in the median SEAMS score by 12.5 points between baseline and 6 months (median 19.5, IQR 5 vs median 32, IQR 11; P<.001). Results of the pill-counting method showed an increase in adherent patients in the intervention group compared to the controls (83/220, 37.2% vs 2/219, 0.9%; P<.001), as well as within the intervention group (difference of n=83, 37.2% of patients, baseline vs 6 months; P<.001). There was a statistically significant difference in the SBP of 7 mmHg between the intervention and control groups (P<.001) at 6 months, a 4 mmHg reduction (P<.001) within the intervention group, and a 3 mmHg increase (P=.314) within the controls. Overall, the number of patients with uncontrolled hypertension decreased by 46 in the intervention group (baseline vs 6 months), but the control group remained unchanged. The variables groups (adjusted odds ratio [AOR] 1.714, 95% CI 2.387-3.825), time (AOR 1.837, 95% CI 1.625-2.754), and age (AOR 1.618, 95% CI 0.225-1.699) significantly contributed (P<.001) to medication adherence. Multi-Aid-Package received a 94.8% acceptability score.

CONCLUSIONS

The novel Multi-Aid-Package is an effective mHealth intervention for enhancing medication adherence and treatment outcomes among patients with hypertension in a low- to middle-income country.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04577157; https://clinicaltrials.gov/study/NCT04577157.

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Idris H, Nugraheni WP, Rachmawati T, Kusnali A, Yulianti A, Purwatiningsih Y, Nuraini S, Susianti N, Faisal DR, Arifin H, Maharani A. How Is Telehealth Currently Being Utilized to Help in Hypertension Management within Primary Healthcare Settings? A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024;21:90. [PMID: 38248553 PMCID: PMC10815916 DOI: 10.3390/ijerph21010090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/29/2023] [Accepted: 01/10/2024] [Indexed: 01/23/2024]

Affiliation(s)

Haerawati Idris Department of Health Administration & Policy, Faculty of Public Health, Sriwijaya University, Indralaya 30662, Indonesia Research Center for Public Health and Nutrition, National Research and Innovation Agency, Central Jakarta 10340, Indonesia; (W.P.N.); (T.R.); (A.K.); (A.Y.); (Y.P.); (S.N.); (N.S.); (D.R.F.)
Wahyu Pudji Nugraheni Research Center for Public Health and Nutrition, National Research and Innovation Agency, Central Jakarta 10340, Indonesia; (W.P.N.); (T.R.); (A.K.); (A.Y.); (Y.P.); (S.N.); (N.S.); (D.R.F.)
Tety Rachmawati Research Center for Public Health and Nutrition, National Research and Innovation Agency, Central Jakarta 10340, Indonesia; (W.P.N.); (T.R.); (A.K.); (A.Y.); (Y.P.); (S.N.); (N.S.); (D.R.F.)
Asep Kusnali Research Center for Public Health and Nutrition, National Research and Innovation Agency, Central Jakarta 10340, Indonesia; (W.P.N.); (T.R.); (A.K.); (A.Y.); (Y.P.); (S.N.); (N.S.); (D.R.F.)
Anni Yulianti Research Center for Public Health and Nutrition, National Research and Innovation Agency, Central Jakarta 10340, Indonesia; (W.P.N.); (T.R.); (A.K.); (A.Y.); (Y.P.); (S.N.); (N.S.); (D.R.F.)
Yuni Purwatiningsih Research Center for Public Health and Nutrition, National Research and Innovation Agency, Central Jakarta 10340, Indonesia; (W.P.N.); (T.R.); (A.K.); (A.Y.); (Y.P.); (S.N.); (N.S.); (D.R.F.)
Syarifah Nuraini Research Center for Public Health and Nutrition, National Research and Innovation Agency, Central Jakarta 10340, Indonesia; (W.P.N.); (T.R.); (A.K.); (A.Y.); (Y.P.); (S.N.); (N.S.); (D.R.F.)
Novia Susianti Research Center for Public Health and Nutrition, National Research and Innovation Agency, Central Jakarta 10340, Indonesia; (W.P.N.); (T.R.); (A.K.); (A.Y.); (Y.P.); (S.N.); (N.S.); (D.R.F.)
Debri Rizki Faisal Research Center for Public Health and Nutrition, National Research and Innovation Agency, Central Jakarta 10340, Indonesia; (W.P.N.); (T.R.); (A.K.); (A.Y.); (Y.P.); (S.N.); (N.S.); (D.R.F.)
Hidayat Arifin Department of Basic Nursing Care, Faculty of Nursing, Universitas Airlangga, Surabaya 60286, Indonesia;
Asri Maharani Division of Nursing, Midwifery & Social Work, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, UK;

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