Health Care and Social Research Centre, Universidad de Castilla-La Mancha, Cuenca, Spain; Rehabilitation in Health Research Center (CIRES), Universidad de las Americas, Santiago, Chile.
Health Care and Social Research Centre, Universidad de Castilla-La Mancha, Cuenca, Spain.
Int J Nurs Stud. 2021 Dec;124:104085. doi: 10.1016/j.ijnurstu.2021.104085. Epub 2021 Sep 5.
Increasingly, health professionals and patients have begun to be involved in eHealth interventions to assist in the self-management of hypertension. Therefore, this study was aimed at comparing the effect of different types of eHealth interventions (phone calls, blood pressure telemonitoring, emails, web-site, smartphone-app, short message service (SMS) and more than two eHealth interventions) on reducing systolic and diastolic blood pressure, increasing adherence to medication treatment, improving physical activity compliance, controlling blood pressure, and improving quality of life (QoL).
A systematic search in MEDLINE (via PubMed), EMBASE, Cochrane Central Register of Controlled Trials, and Web of Science databases was conducted to identify experimental studies addressing the effect of eHealth interventions on the self-management of hypertension. Comparative evaluation of the eHealth interventions effect were performed by conducting a standard pairwise meta-analysis and a network meta-analysis for direct and indirect comparisons between eHealth interventions and control/non-intervention.
Fifty-one studies were included in the analysis showing a moderate effect size for more than two types of eHealth interventions (-0.46; 95%CI: -0.64, -0.27, p < 0.001 and -0.29; 95%CI: -0.46, -0.13, p < 0.001), phone calls (-0.37; 95%CI: -0.57, -0.17, p < 0.001 and -0.29; 95%CI: -0.52, -0.07, p = 0.011) and smartphone-app (-0.26; 95%CI: -0.50, -0.01, p = 0.040 and -0.40; 95%CI: -0.70, -0.10, p = 0.010) on reducing both systolic and diastolic blood pressure, respectively. Additionally, i) smartphone-app improved medication adherence by 45%; ii) more than two types of eHealth interventions and emails improved physical activity compliance by 18% and 57% respectively; ii) more than two types of eHealth interventions, phone calls, blood pressure telemonitoring, website and SMS improved blood pressure control between 16% and 30%; and iv) blood pressure telemonitoring showed a week effect on QoL CONCLUSIONS: Our study reported eHealth to be a suitable intervention for the self-management of hypertension. Considering our results and the population's accessibility to eHealth devices, eHealth could be a useful and largely scalable tool for the self-management of hypertension.
PROSPERO CRD42020187468.
越来越多的医疗专业人员和患者开始参与电子健康干预措施，以协助高血压的自我管理。因此，本研究旨在比较不同类型的电子健康干预措施（电话、血压远程监测、电子邮件、网站、智能手机应用程序、短信服务和两种以上的电子健康干预措施）对降低收缩压和舒张压、提高药物治疗依从性、改善身体活动依从性、控制血压和改善生活质量（QoL）的效果。
通过 MEDLINE（通过 PubMed）、EMBASE、Cochrane 对照试验中心注册库和 Web of Science 数据库进行系统检索，以确定关于电子健康干预措施对高血压自我管理影响的实验研究。通过进行标准的两两荟萃分析和直接和间接比较电子健康干预措施与对照/非干预措施的网络荟萃分析，对电子健康干预措施的效果进行了比较评估。
共纳入 51 项研究，结果显示，两种以上类型的电子健康干预措施（-0.46；95%置信区间：-0.64，-0.27，p<0.001 和-0.29；95%置信区间：-0.46，-0.13，p<0.001）、电话（-0.37；95%置信区间：-0.57，-0.17，p<0.001 和-0.29；95%置信区间：-0.52，-0.07，p=0.011）和智能手机应用程序（-0.26；95%置信区间：-0.50，-0.01，p=0.040 和-0.40；95%置信区间：-0.70，-0.10，p=0.010）分别在降低收缩压和舒张压方面均有中度的效果。此外，i）智能手机应用程序提高了 45%的药物治疗依从性；ii）两种以上类型的电子健康干预措施和电子邮件分别提高了 18%和 57%的身体活动依从性；iii）两种以上类型的电子健康干预措施、电话、血压远程监测、网站和短信分别提高了 16%至 30%的血压控制；iv）血压远程监测对生活质量的影响具有周效性。
我们的研究报告称，电子健康是高血压自我管理的一种合适的干预措施。考虑到我们的结果和人口对电子健康设备的可及性，电子健康可能是高血压自我管理的一种有用且具有较大可扩展性的工具。
PROSPERO CRD42020187468。
