Abstract Body: Introduction: Hypertension (HTN) is a leading global cause of cardiovascular morbidity and mortality. Poor medication adherence, frequently below 50%, critically undermines HTN management and blood pressure (BP) control. Mobile health (mHealth) applications, leveraging ubiquitous smartphone technology, offer a promising, scalable approach to address these adherence challenges and improve patient engagement.
Hypothesis: We assessed the hypothesis that mHealth interventions, by synthesizing evidence from recent systematic reviews and meta-analyses of randomized controlled trials (RCTs), significantly improve medication adherence and reduce BP in adult patients with HTN.
Methods: This work synthesizes findings from recent, high-quality systematic reviews and meta-analyses of RCTs. These reviews evaluated mHealth interventions (e.g., smartphone app-based self-monitoring, reminders, educational content) in adult populations with HTN. Primary outcomes were medication adherence and changes in systolic BP (SBP) and diastolic BP. Quantitative data, including Standardized Mean Differences (SMD) and Odds Ratios (OR), were analyzed from these reviews.
Results: Synthesized evidence from major meta-analyses, collectively involving thousands of participants (e.g., N=6428 for one adherence outcome, N=1495 for another, N=7301 for SBP data), consistently demonstrated significant benefits. mHealth interventions substantially improved medication adherence. For instance, one meta-analysis found app-based self-monitoring increased adherence with an SMD of 0.78 (95% Confidence Interval [CI] 0.22-1.34) and increased the odds of achieving clinically meaningful adherence by nearly four-fold (OR 3.83, 95% CI 1.25-11.76). Another reported an SMD for adherence change of 0.41 (95% CI 0.02-0.79). Significant SBP reductions were also observed, with weighted mean differences ranging from -1.64 mmHg (95% CI -2.73 to -0.55) to -2.28 mmHg (95% CI -3.90 to -0.66). Interventions incorporating tailored advice yielded greater SBP reductions (e.g., -2.92 mmHg).
Conclusions: In conclusion, this synthesis of current evidence robustly confirms that mHealth interventions significantly enhance medication adherence and achieve clinically relevant reductions in BP among adults with HTN. mHealth applications represent valuable, scalable tools for integration into routine clinical practice to improve hypertension management and patient outcomes.