Effectiveness, reach, uptake, and feasibility of digital health interventions for adults with hypertension: a systematic review and meta-analysis of randomised controlled trials
| Autor: | George Siopis, George Moschonis, Evette Eweka, Jenny Jung, Dominika Kwasnicka, Bernard Yeboah-Asiamah Asare, Vimarsha Kodithuwakku, Ruben Willems, Nick Verhaeghe, Lieven Annemans, Rajesh Vedanthan, Brian Oldenburg, Yannis Manios, Enying Gong, Konstantinos Votis, Sofia Segkouli, Andreas Triantafyllidis, Odysseas Kyparissis, Ioannis Paliokas, Eleftheria Polychroniou, Dirk De Craemer, Kostas Anastasiou, Konstantinos Tserpes, Christina Mavrogianni, Eva Karaglani, Electra Kalogerakou, Maria Maragkoudaki, Agathi Ntzouvani, Katerina Kontochristopoulou, Sabine Dupont, Elizabeth Dupont, Leo Dauzon, Maartje Roskams, Niamh Lennox-Chhugani, Martin Perrin, Niamh Daly Day, Georgina Ferrer, Orla Snook, Edelweiss Aldasoro, Alejandro Gil-Salmerón, Pilar Gangas Peiró, Darren Curran, Fiona Lyne, Nereide A. Curreri, Nazzareno Pierantozzi, Claudia D'Antonio, Giacomo Vespasiani, Teresa Almonti, Helen Skouteris, Tracy Taylor, Melissa Savaglio, Konstantinos Makrilakis, George Stergiou, Stavros Liatis, George Karamanakos, Chrysi Koliaki, Anastasios Kollias, Eva Zikou, Haris Dimosthenopoulos, Keng-Yen Huang, Samrachana Adhikari, Kun Qian, Julia Dickhaus, Kimberly Carney, Farhan Sahito, Dusan Pavlovic, Djordje Djokic, Arzoo Sahito, Gisella Battalova, Chiara Seghieri, Sabina Nutti, Milena Vanieri, Nicola Belle, Gaia Bertarelli, Paola Cantarelli, Francesca Ferre, Anna Noci, Constanza Tortu, Nadia Bozzi, Dina Ferrari, Rachele Borelli, Violeta Iotova, Yoto Yotov, Natalia Usheva, Anna Kozhuharova, Vanya Russeva, Vanya Marinova, Sonya Koleva, Virginia Atanasova, Tanya Stefanova, Kaloyan Tsochev, Luis Moreno Aznar, Rosa Magallón Botaya, Gloria Bueno Lozano, Pilar De Miguel-Etayo, Esther Ma Gonzalez-Gil, María L. Miguel-Berges, Susana Pérez, Bárbara Oliván Blázquez, Natalia Giménez-Legarre, Florian Toti, Skerdi Prifti, Blerina Bombaj, Ditila Doracaj, Ornela Laze, Adriana Lapardhaja, Luftime Bruka |
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| Jazyk: | angličtina |
| Rok vydání: | 2023 |
| Předmět: |
Adult
hypertension Medicine (miscellaneous) Health Informatics Smart-phone applications Systolic and diastolic blood pressures Health Information Management Settore SECS-P/07 - Economia Aziendale Medicine and Health Sciences Humans Decision Sciences (miscellaneous) human Settore SECS-S/05 - Statistica Sociale Randomized Controlled Trials as Topic Risk assessment blood pressure feasibility study Websites Health interventions Grading Smartphones Meta-analysis Randomized controlled trial Systolic blood pressure Feasibility Studies Systematic Review Adult Blood Pressure Feasibility Studies Humans Hypertension Randomized Controlled Trials as Topic Grading Risk assessment Smartphones Websites Health interventions Meta-analysis Randomized controlled trial Smart-phone applications Systematic Review Systolic and diastolic blood pressures Systolic blood pressure adult blood pressure feasibility study human hypertension |
| Zdroj: | LANCET DIGITAL HEALTH |
| ISSN: | 2589-7500 |
| Popis: | Background 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. |
| Databáze: | OpenAIRE |
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