Pharmacist-Led Digital Health Interventions to Improve Treatment Outcomes in Patients with Hypertension - A Systematic Review.

Abstract

With the advancement of digital technologies, pharmacist-led digital health interventions (DHI) have emerged as a promising strategy to improve hypertension management. This systematic review evaluated randomized controlled trials (RCTs) published from December 1996 to May 2024, identified via PubMed by incorporating key concepts including DHIs, pharmaceutical care, and hypertension. The review included RCTs assessed telephone-, web-, or mobile-based pharmacist-led DHI compared to usual care (UC). Primary outcomes included blood pressure (BP) reduction, medication adherence, and identification of drug-related problems (DRPs). Following the modified Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, fourteen RCTs met inclusion criteria, with interventions categorized as telephone monitoring (n = 6), web-based interventions (n = 5), and mobile-based interventions (n = 3). Eight studies (57.14%) showed significant BP reduction in the intervention group (IG), one (7.14%) reported diastolic blood pressure (DBP) reduction only, and one found no significant BP difference between IG and control group (CG). One study reported a higher BP control rate in the IG (OR = 3.64). All studies evaluating adherence (n = 5) showed improvements, and one reported enhanced DRP identification. We identified that interventions' effectiveness is influenced by frequency of the intervention, personalization, and patient engagement. Designing an intervention compatible with each patient and providing sufficient guidance may improve effectiveness. As most studies were conducted in high-income countries, further research is needed to ensure the applicability of DHIs in diverse settings. In conclusion, pharmacist-led DHIs demonstrate potential in improving hypertension outcomes, with further validation required to support their implementation across varied healthcare systems.