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Digital interventions to promote self management in adults with hypertension systematic review and meta analysis

Digital interventions to promote self management in adults with hypertension systematic review and meta analysis
Digital interventions to promote self management in adults with hypertension systematic review and meta analysis
Objective: To synthesize the evidence for using interactive digital interventions (IDIs) to support patient self-management of hypertension, and to determine their impact on control and reduction of blood pressure.

Method: Systematic review with meta-analysis was undertaken with a search performed in MEDLINE, EMBASE, CINAHL, PsycINFO, ERIC, Cochrane Library, DoPHER, TROPHI, Social Science Citation Index and Science Citation Index. The population was adults (>18 years) with hypertension, intervention was an IDI and the comparator was usual care. Primary outcomes were change in SBP and DBP. Only randomized controlled trials and studies published in journals and in English were eligible. Eligible IDIs included interventions accessed through a computer, smartphone or other hand-held device.

Results: Four out of seven studies showed a significantly greater reduction for intervention compared to usual care for SBP, with no difference found for three. Overall, IDIs significantly reduced SBP, with the weighted mean difference being ?3.74?mmHg [95% confidence interval (CI) ?2.19 to ?2.58] with no heterogeneity observed (I-squared?=?0.0%, P?=?0.990). For DBP, four out of six studies indicated a greater reduction for intervention compared to controls, with no difference found for two. For DBP, a significant reduction of ?2.37?mmHg (95% CI ?0.40 to ?4.35) was found, but considerable heterogeneity was noted (I-squared?=?80.1%, P?=?<0.001).

Conclusion: IDIs lower both SBP and DBP compared to usual care. Results suggest these findings can be applied to a wide range of healthcare systems and populations. However, sustainability and long-term clinical effectiveness of these interventions remain uncertain
0263-6352
600-612
McLean, G.
58e42e52-5dcb-4a9b-9af6-f4d5bc9fb50f
Band, B.
be8901bb-bb1b-4131-8e19-c1d4a3bdfb8d
Saunderson, K.
ef62b69e-0c96-4f80-aeae-99c35920d125
Hanlon, P.
b2209b13-b860-4bf9-b2fc-c8b53e64ec16
Murray, E.
7bf1a8d5-dff0-4748-8060-e96377a70216
Little, P.
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
McManus, R.
5daa415d-e0bc-471a-8b8e-e58a77d41ef0
Yardley, L.
64be42c4-511d-484d-abaa-f8813452a22e
Mair, F.
91c6b764-6f99-4032-923f-1ca7fdb2f471
McLean, G.
58e42e52-5dcb-4a9b-9af6-f4d5bc9fb50f
Band, B.
be8901bb-bb1b-4131-8e19-c1d4a3bdfb8d
Saunderson, K.
ef62b69e-0c96-4f80-aeae-99c35920d125
Hanlon, P.
b2209b13-b860-4bf9-b2fc-c8b53e64ec16
Murray, E.
7bf1a8d5-dff0-4748-8060-e96377a70216
Little, P.
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
McManus, R.
5daa415d-e0bc-471a-8b8e-e58a77d41ef0
Yardley, L.
64be42c4-511d-484d-abaa-f8813452a22e
Mair, F.
91c6b764-6f99-4032-923f-1ca7fdb2f471

McLean, G., Band, B., Saunderson, K., Hanlon, P., Murray, E., Little, P., McManus, R., Yardley, L. and Mair, F. (2016) Digital interventions to promote self management in adults with hypertension systematic review and meta analysis. Journal of Hypertension, 34 (4), 600-612. (doi:10.1097/HJH.0000000000000859). (PMID:26845284)

Record type: Article

Abstract

Objective: To synthesize the evidence for using interactive digital interventions (IDIs) to support patient self-management of hypertension, and to determine their impact on control and reduction of blood pressure.

Method: Systematic review with meta-analysis was undertaken with a search performed in MEDLINE, EMBASE, CINAHL, PsycINFO, ERIC, Cochrane Library, DoPHER, TROPHI, Social Science Citation Index and Science Citation Index. The population was adults (>18 years) with hypertension, intervention was an IDI and the comparator was usual care. Primary outcomes were change in SBP and DBP. Only randomized controlled trials and studies published in journals and in English were eligible. Eligible IDIs included interventions accessed through a computer, smartphone or other hand-held device.

Results: Four out of seven studies showed a significantly greater reduction for intervention compared to usual care for SBP, with no difference found for three. Overall, IDIs significantly reduced SBP, with the weighted mean difference being ?3.74?mmHg [95% confidence interval (CI) ?2.19 to ?2.58] with no heterogeneity observed (I-squared?=?0.0%, P?=?0.990). For DBP, four out of six studies indicated a greater reduction for intervention compared to controls, with no difference found for two. For DBP, a significant reduction of ?2.37?mmHg (95% CI ?0.40 to ?4.35) was found, but considerable heterogeneity was noted (I-squared?=?80.1%, P?=?<0.001).

Conclusion: IDIs lower both SBP and DBP compared to usual care. Results suggest these findings can be applied to a wide range of healthcare systems and populations. However, sustainability and long-term clinical effectiveness of these interventions remain uncertain

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More information

Accepted/In Press date: 17 December 2015
Published date: 1 April 2016
Additional Information: Open Access article - URL to article on publishers site given

Identifiers

Local EPrints ID: 393786
URI: http://eprints.soton.ac.uk/id/eprint/393786
ISSN: 0263-6352
PURE UUID: 690556de-2306-4b56-9fa4-4582c6a5cba4
ORCID for B. Band: ORCID iD orcid.org/0000-0001-5403-1708
ORCID for L. Yardley: ORCID iD orcid.org/0000-0002-3853-883X

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Date deposited: 05 May 2016 08:57
Last modified: 15 Mar 2024 03:50

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Contributors

Author: G. McLean
Author: B. Band ORCID iD
Author: K. Saunderson
Author: P. Hanlon
Author: E. Murray
Author: P. Little
Author: R. McManus
Author: L. Yardley ORCID iD
Author: F. Mair

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