Sukpattanasrikul Saowaluck, Singha-Dong Naruemol, Sitthimongkol Yajai, Anonjarn Kanlayawee
Faculty of Nursing, Mahidol University, Bangkok, Thailand.
Institute of Nursing, Suranaree University of Technology, Nakhon Ratchasima, Thailand.
Int J Nurs Sci. 2025 Apr 12;12(3):225-232. doi: 10.1016/j.ijnss.2025.04.001. eCollection 2025 May.
This systematic review aimed to identify effective and cost-effective digital health interventions to improve self-management behaviors, blood pressure control, and cardiovascular risk reduction.
A search for randomized and non-randomized control trials of digital health interventions among patients with uncontrolled hypertension was conducted from the databases of Embase, PubMed, Scopus, CINAHL, Web of Science, PsycINFO, Thai Journal Online (ThaiJO), the Faculty of Nursing Mahidol University (FON-MU) Nursing Research Database, and gray literature. After conducting the literature screening, the authors completed data extraction, and the risk of bias was assessed using the Joanna Briggs Institute randomized controlled trial checklist and the Joanna Briggs Institute critical appraisal checklist for quasi-experimental studies.
The study included 22 articles, comprising 30 to 4,118 patients with uncontrolled hypertension. This review classified and summarized the components of digital health interventions and their effects on hypertensive outcomes. It was found that the key elements of digital health interventions include health education, reminders, self-monitoring, feedback and consultation, and instrumental support. Moreover, approximately 81.81 % ( = 18) of the digital health interventions involved healthcare providers participating in feedback and consultation. Additionally, digital health interventions effectively improve hypertensive outcomes such as self-management behaviors, blood pressure control, and cardiovascular risk reduction, providing cost-effectiveness.
Based on the available literature, digital health interventions have been shown to effectively enhance behavioral, clinical, and economic outcomes for individuals with uncontrolled hypertension. Moreover, the combination of digital health interventions and healthcare providers' interventions can potentially help patients with uncontrolled hypertension improve adherence to self-management when compared to stand-alone digital health interventions. Digital health interventions to support self-management interventions should be developed for patients by healthcare providers.
本系统评价旨在确定有效且具有成本效益的数字健康干预措施，以改善自我管理行为、控制血压并降低心血管风险。
从Embase、PubMed、Scopus、CINAHL、Web of Science、PsycINFO、泰国在线期刊（ThaiJO）、玛希隆大学护理学院（FON-MU）护理研究数据库以及灰色文献数据库中搜索针对血压控制不佳患者的数字健康干预随机对照试验和非随机对照试验。在进行文献筛选后，作者完成数据提取，并使用乔安娜·布里格斯研究所随机对照试验清单和乔安娜·布里格斯研究所准实验研究批判性评价清单评估偏倚风险。
该研究纳入22篇文章，涉及30至4118名血压控制不佳的患者。本评价对数字健康干预的组成部分及其对高血压结局的影响进行了分类和总结。发现数字健康干预的关键要素包括健康教育、提醒、自我监测、反馈与咨询以及工具性支持。此外，约81.81%（=18项）的数字健康干预涉及医疗保健提供者参与反馈与咨询。此外，数字健康干预有效改善了高血压结局，如自我管理行为、血压控制和心血管风险降低，并具有成本效益。
根据现有文献，数字健康干预已被证明能有效改善血压控制不佳个体的行为、临床和经济结局。此外，与单纯的数字健康干预相比，数字健康干预与医疗保健提供者干预相结合可能有助于血压控制不佳的患者提高自我管理依从性。医疗保健提供者应为患者开发支持自我管理干预的数字健康干预措施。
