What is the clinical evidence from this study?

Study design: Other. Population: Hypertension (n=185). Intervention: eTansiyon smartphone application vs. Routine health care. Primary outcome: Office systolic blood pressure (MD 9.5, 95% CI 4.6-13.4, p=<0.001).

January 1, 2022Open Access

Effect of eTansiyon smartphone application on hypertension control

Q: What are the key findings of this study?

The eTansiyon smartphone application significantly reduced office systolic blood pressure by a mean difference of 9.5 mmHg compared to routine care in patients with hypertension.

EYEmre YılmazDumlupinar University AUArzu UzunerMarmara University MBMensur BajgoraMarmara University

Key Result

The eTansiyon smartphone application significantly reduced office systolic blood pressure by a mean difference of 9.5 mmHg compared to routine care in patients with hypertension.

Structured PICO

Does the eTansiyon smartphone application improve blood pressure control in adult patients with essential hypertension?

Population

185 adult patients (aged 30-74 years) diagnosed with essential hypertension for at least one year, using antihypertensive medications, and possessing a smartphone and sphygmomanometer. Mean age 56.9, based in Turkey (Istanbul and Kocaeli). Key exclusions: secondary hypertension, hypertension during pregnancy, BP ≥180/110 mmHg at first visit, stage 3 hypertension with end-organ damage, history of stroke or coronary revascularization in the last 3 months, chronic renal failure, and heart failure.

Intervention

eTansiyon smartphone application (providing educational videos, instant notifications for pill reminding, lifestyle advice, and BP/medication tracking) added to standard follow-up for at least 4 months.

Comparator

Standard follow-up for at least 4 months without the smartphone application.

Outcome

Decrease in blood pressure values (office and home SBP/DBP) and increase in blood pressure control at target (per 2018 ESC/ESH guidelines) at the end of the follow-up period.surrogate

The use of a dedicated smartphone application (eTansiyon) significantly improved blood pressure control, medication adherence, and hypertension knowledge in primary care patients.

Main Result

Effect estimate: MD 9.5 (95% CI 4.6-13.4)

Absolute Event Rate: 128.3% vs 137.8%

p-value: p=<0.001

Limitations

The participants were not randomized at Family Health Centers; randomization was performed at the FHU level.
The six units in different locations included in the study may not be sufficient to disseminate the results to the general population.

Abstract

Abstract Aim: To investigate the effectiveness of eTansiyon smartphone application in blood pressure control in patients with hypertension. Background: Global prevalence of hypertension and the burden of chronic illness care, especially in primary care, are increasing in world. We have developed eTansiyon to ensure the continuity of patient-physician relationship, so it may help to improve the lifestyle of patients with hypertension, increase their adherence to treatment and achieve the target blood pressure. Methods: This study was a non-randomized controlled study. The sample was selected by random sampling method among the patients registered in 6 Family Health Units (FHUs). Randomization was performed at the FHU level; the units were randomized to 4 control group (CG) and 2 intervention group (IG), so that randomization in this study was 2:1. Both groups were followed up for at least four months. In addition to CG, IG were provided to use eTansiyon . Obtained data were analysed to evaluate differences between groups at the beginning and end of the study, intra-group changes after follow-up and interaction between groups and follow-up period. Findings: The study was performed with 124 patients in CG and 61 patients in IG. At the end of the study, the average systolic blood pressure/diastolic blood pressure (SBP/DBP) of office and home was significantly lower in IG compared to CG ( P < 0.001, MD 9.5 mmHg; P = 0.007, MD 3.8 mmHg; P < 0.001, MD 10.6 mmHg; P < 0.001, MD 4.8 mmHg, respectively), and it was found that the proportion of people with target blood pressure in IG was significantly higher than CG ( P < 0.001, 49.2%( n = 30) and 22.6%( n = 28), respectively). Repeated measures ANOVA and generalized estimating equations results showed that follow-up period and interaction between groups were significant in terms of office and home SBP/DBP and target blood pressure level during follow-up period ( P < 0.001, P < 0.001, P < 0.001, P < 0.001, P < 0.024, respectively).

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