Key result
A mHealth wearable and app fails to reduce SBP versus usual care in adjusted analyses.
Why the study?
Despite the increasing popularity of mHealth, little evidence indicates that they can improve health outcomes in low-resource rural settings.
Does a mHealth intervention (wearable device and smartphone app) improve cardiovascular health risk factors and compliance in individuals with hypertension in a low-resource rural setting?
RCT (n=134)
Single-blind
1:1
Yes
Does a mHealth intervention (wearable device and smartphone app) improve cardiovascular health risk factors and compliance in individuals with hypertension in a low-resource rural setting?
Mean Difference: -7.265 (95% CI -12.89–-1.64)
Absolute Event Rate: -8.52% vs -1.25%
p-value: p=0.012
A mHealth intervention utilizing a wearable device and smartphone app significantly reduced systolic blood pressure and improved self-reported compliance and quality of life in rural patients with hypertension.
mHealth with wearables and apps improves SBP, adherence, and QoL in rural hypertension; extends RCT evidence for digital tools in low-resource settings.
Background Despite the increasing popularity of mHealth, little evidence indicates that they can improve health outcomes. Mobile health interventions (mHealth) have been shown as an attractive approach for health-care systems with limited resources. To determine whether mHealth would reduce blood pressure, promote weight loss, and improve hypertension compliance, self-efficacy and life quality in individuals with hypertension living in low-resource rural settings in Hubei, China. Methods In this parallel-group, randomized controlled trial, we recruited individuals from health-care centers, home visits, and community centers in low-resource rural settings in Hubei, China. Of 200 participants who were screened, 148 completed consent, met inclusion criteria, and were randomly assigned in a ratio of 1:1 to control or intervention. Intervention group participants were instructed to use the Monitoring Wearable Device and download a Smartphone Application, which includes reminder alerts, adherence reports, medical instruction and optional family support. Changes in the index of Cardiovascular health risk factors from baseline to end of follow-up. Secondary outcomes were change in hypertension compliance, self-efficacy and life quality at 12 weeks. Results Participants (n = 134; 66 in the intervention group and 68 controls) had a mean age of 61.73 years, 61.94% were male. After 12 weeks, the mean (SD) systolic blood pressure decreased by 8.52 (19.73) mm Hg in the intervention group and by 1.25 (12.47) mm Hg in the control group (between-group difference, −7.265 mm Hg; 95% CI, −12.89 to −1.64 mm Hg; P = 0.012), While, there was no difference in the change in diastolic blood pressure between the two groups (between-group difference, −0.41 mm Hg; 95% CI, −3.56 to 2.74 mm Hg; P = 0.797). After 12 weeks of follow-up, the mean (SD) hypertension compliance increased by 7.35 (7.31) in the intervention group and by 3.01 (4.92) in the control group (between-group difference, 4.334; 95% CI, 2.21 to −6.46; P < 0.01), the mean (SD) hypertension compliance increased by 12.89 (11.95) in the intervention group and by 5.43 (10.54) in the control group (between-group difference, 7.47; 95% CI, 3.62 to 11.31; P < 0.01), the mean (SD) physical health increased by 12.21 (10.77) in the intervention group and by 1.54 (7.18) in the control group (between-group difference, 10.66; 95% CI, 7.54–13.78; P < 0.01), the mean (SD) mental health increased by 13.17 (9.25) in the intervention group and by 2.55 (5.99) in the control group (between-group difference, 10.93; 95% CI, 7.74 to 14.12; P < 0.01). Conclusions Among participants with uncontrolled hypertension, individuals randomized to use a monitoring wearable device with a smartphone application had a significant improvement in self-reported hypertension compliance, self-efficacy, life quality, weight loss and diastolic blood pressure, but no change in systolic blood pressure compared with controls.
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Tan et al. (2023) conducted an RCT in Hypertension (n=134). mHealth intervention (wearable device and smartphone app) vs. Usual health care was evaluated on Change in systolic blood pressure from baseline to 12 weeks (MD -7.265 mm Hg, 95% CI -12.89 to -1.64, p=0.012). A mHealth intervention using a wearable device and smartphone app reduced unadjusted systolic blood pressure by 7.265 mm Hg compared to usual care at 12 weeks, though adjusted analyses showed no significant difference.
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