The digital prescription: A systematic review and meta-analysis of smartphone apps for blood pressure control

• Digital Health Intervention reduces systolic blood pressure (SBP), showing significant positive effects. • Meta-analyses show interventions delivered by smartphone apps reduce SBP by −1.94 mm Hg, with significant p-values. • The study underscores the importance of tailoring digital health interventions to individual patient needs and preferences to maximise their effectiveness and long-term impact on blood pressure control. • This review identifies key knowledge gaps and calls for future research to optimise digital design, assess long-term outcomes, and address disparities in access and effectiveness across diverse patient populations. Assess the effectiveness of digital health interventions (DHIs) in reducing blood pressure (BP) among individuals with high blood pressure and identify the impact of age, sex, and phone-based delivery methods on BP. A systematic review and meta -analysis was undertaken according to the PRISMA and JBI. A comprehensive search was conducted across multiple databases. Randomised controlled trials (RCTs), mixed methods, descriptive, and experimental studies enrolling adult patients (≥ 18 years) with high BP and containing DHIs with blood pressure management aspect were included. We used a random-effects meta -analysis weighted mean difference (MD) between the comparison groups to pool data from the included studies. The outcome included the pooled MD reflecting systolic (SBP) or diastolic (DBP) change from baseline to 6-month period. Risk of bias was assessed using standardised tools. Thirty-six studies with 33,826 participants were included in the systematic review. The pooled estimate (26 RCTs) showed a significant reduction in SBP (MD = −1.45 mmHg, 95 % CI: −2.18 to −0.71) but not in DBP (MD = −0.50 mmHg, 95 % CI: −1.03 to 0.03), with evidence of some heterogeneity. Subgroup analysis indicated that smartphone app interventions were more effective in lowering SBP than short message services (SMS) or mobile phone calls. Additionally, the interventions significantly reduced the SBP compared with the control, regardless of participant sex. Our findings indicate that DHIs, particularly smartphone apps, can lower SBP after 6 months in individuals with hypertension or high-risk factors, although changes might not be clinically significant. Further research is needed to understand the long-term impact and optimal implementation of DHIs for BP management across diverse populations.