Self-Health Monitoring by Smart Devices and Ontology Technology for Older Adults With Uncontrolled Hypertension: Quasi-Experimental Study.

Background: Hypertension is a prevalent concern among older adults, often leading to complex cardiovascular complications when uncontrolled. Telenursing technology facilitates self-management, and the integration of domain-specific ontology allows real-time interpretation of behavioral and biometric data to provide personalized recommendations, enhancing patient engagement and self-care.

Objective: This study aimed to examine the within-group and between-group effects of self-health monitoring using smart devices combined with ontology technology on hypertension-controlling behavior and mean arterial pressure among older adults with uncontrolled hypertension.

Methods: The quasi-experimental design was conducted with 91 older adults in Bangkok, Thailand (46 experimental and 45 comparison participants). Participants in the experimental group used the "HT GeriCare@STOU" app on smartphones, linked to smartwatches for blood pressure monitoring, step count, and sleep pattern, with telenursing support via video calls. Data on hypertension-controlling behavior were collected using a validated questionnaire (Cronbach α=0.83; content validity index=0.98). Descriptive statistics and t tests were used to analyze within-group and between-group differences.

Results: Within-group analysis revealed that experimental participants showed improved hypertension-controlling behavior and reduced mean arterial pressure after the program. Between-group comparisons indicated that mean arterial pressure in the experimental group was significantly lower than in the comparison group (P<.05), although hypertension-controlling behavior did not differ significantly between groups. Older adult participants and nurses reported high satisfaction, noting that real-time feedback increased awareness of blood pressure and motivated independent health behavior adjustments.

Conclusions: Self-health monitoring using smart devices integrated with ontology technology effectively improved physiological outcomes and supported self-management in older adults with uncontrolled hypertension. The ontology framework enabled personalized, real-time decision support, highlighting its novelty, and potential to enhance nursing practice. Future studies with larger samples and longer follow-up are recommended to further evaluate the intervention's effectiveness and scalability.