Efficacy and cost-effectiveness of digital health interventions in improving hypertensive outcomes among patients with uncontrolled hypertension: A systematic review

IF 2.9 3区医学 Q1 NURSING

International Journal of Nursing Sciences Pub Date : 2025-05-01 DOI:10.1016/j.ijnss.2025.04.001

Saowaluck Sukpattanasrikul , Naruemol Singha-Dong , Yajai Sitthimongkol , Kanlayawee Anonjarn

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引用次数: 0

Abstract

Objectives

This systematic review aimed to identify effective and cost-effective digital health interventions to improve self-management behaviors, blood pressure control, and cardiovascular risk reduction.

Methods

A search for randomized and non-randomized control trials of digital health interventions among patients with uncontrolled hypertension was conducted from the databases of Embase, PubMed, Scopus, CINAHL, Web of Science, PsycINFO, Thai Journal Online (ThaiJO), the Faculty of Nursing Mahidol University (FON-MU) Nursing Research Database, and gray literature. After conducting the literature screening, the authors completed data extraction, and the risk of bias was assessed using the Joanna Briggs Institute randomized controlled trial checklist and the Joanna Briggs Institute critical appraisal checklist for quasi-experimental studies.

Results

The study included 22 articles, comprising 30 to 4,118 patients with uncontrolled hypertension. This review classified and summarized the components of digital health interventions and their effects on hypertensive outcomes. It was found that the key elements of digital health interventions include health education, reminders, self-monitoring, feedback and consultation, and instrumental support. Moreover, approximately 81.81 % (n = 18) of the digital health interventions involved healthcare providers participating in feedback and consultation. Additionally, digital health interventions effectively improve hypertensive outcomes such as self-management behaviors, blood pressure control, and cardiovascular risk reduction, providing cost-effectiveness.

Conclusion

Based on the available literature, digital health interventions have been shown to effectively enhance behavioral, clinical, and economic outcomes for individuals with uncontrolled hypertension. Moreover, the combination of digital health interventions and healthcare providers’ interventions can potentially help patients with uncontrolled hypertension improve adherence to self-management when compared to stand-alone digital health interventions. Digital health interventions to support self-management interventions should be developed for patients by healthcare providers.

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数字健康干预在改善未控制高血压患者高血压结局方面的疗效和成本效益：一项系统综述

本系统综述旨在确定有效且具有成本效益的数字健康干预措施，以改善自我管理行为、血压控制和心血管风险降低。方法从Embase、PubMed、Scopus、CINAHL、Web of Science、PsycINFO、Thai Journal Online （ThaiJO）、Mahidol大学护理学院（on- mu）护理研究数据库和灰色文献等数据库中检索数字健康干预在未控制高血压患者中的随机和非随机对照试验。在进行文献筛选后，作者完成数据提取，并使用Joanna Briggs Institute随机对照试验检查表和Joanna Briggs Institute准实验研究关键评价检查表评估偏倚风险。结果本研究纳入22篇文章，包括30 ~ 4118例未控制的高血压患者。这篇综述对数字健康干预的组成部分及其对高血压结局的影响进行了分类和总结。研究发现，数字卫生干预措施的关键要素包括健康教育、提醒、自我监测、反馈和咨询以及工具性支持。此外，大约81.81% （n = 18）的数字健康干预措施涉及医疗保健提供者参与反馈和咨询。此外，数字健康干预措施有效地改善了高血压的结局，如自我管理行为、血压控制和心血管风险降低，提供了成本效益。根据现有文献，数字健康干预已被证明可以有效地改善未控制的高血压患者的行为、临床和经济结果。此外，与独立的数字健康干预措施相比，数字健康干预措施和医疗保健提供者的干预措施相结合，有可能帮助未受控制的高血压患者提高自我管理的依从性。卫生保健提供者应为患者开发支持自我管理干预措施的数字卫生干预措施。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Nursing Sciences Nursing-Nursing (all)

CiteScore

6.10

自引率

2.60%

发文量

408

审稿时长

25 days

期刊介绍： This journal aims to promote excellence in nursing and health care through the dissemination of the latest, evidence-based, peer-reviewed clinical information and original research, providing an international platform for exchanging knowledge, research findings and nursing practice experience. This journal covers a wide range of nursing topics such as advanced nursing practice, bio-psychosocial issues related to health, cultural perspectives, lifestyle change as a component of health promotion, chronic disease, including end-of-life care, family care giving. IJNSS publishes four issues per year in Jan/Apr/Jul/Oct. IJNSS intended readership includes practicing nurses in all spheres and at all levels who are committed to advancing practice and professional development on the basis of new knowledge and evidence; managers and senior members of the nursing; nurse educators and nursing students etc. IJNSS seeks to enrich insight into clinical need and the implications for nursing intervention and models of service delivery. Contributions are welcomed from other health professions on issues that have a direct impact on nursing practice.