Zhang Nanxiang, Lin Hai, Wu Xichun, Zheng Yongjun, Yin Jianan, Ding Chonglong, Pan Qi, Yang Shuo, Luo Hao, Zou Xinyan, Ge Yingfeng, Zhang Jinxin
Department of Medical Statistics, School of Public Health, Sun Yat-sen University, #74 Zhongshan 2nd Road, Guangzhou, China, 86 13660501365.
Zhongshan Center for Disease Control and Prevention, Zhongshan, China.
J Med Internet Res. 2025 Jul 31;27:e71668. doi: 10.2196/71668.
Limited research has investigated the influence of patient engagement on the long-term effects of mobile health (mHealth) interventions, particularly among older adults.
This study aimed to examine the long-term impact of a social media-driven mHealth intervention on blood pressure control among older Chinese individuals with hypertension, through repeated measurements of patient engagement and outcomes at 5 preset time points.
The study included older Chinese individuals with hypertension between 2017 and 2022. Participants received a hypertension self-management program via the WeChat social media app (Tencent Holdings Ltd), which provided clinically based digital coaching. Blood pressure measurements were taken repeatedly using a home blood pressure monitor (HBPM) connected to the app at baseline, 3, 6, 9, and 12 months. Patient engagement was evaluated based on the frequency of completed measurements at corresponding follow-ups. Latent growth curve models (LGCMs) served to assess the impact of patient engagement on blood pressure among older individuals with hypertension across preset points.
A total of 1723 patients completed the 12-month follow-up (average age 70.1, SD 6.8 years; 890/1723, 51.7% female; and baseline systolic blood pressure 137.2 mm Hg). LGCMs revealed systolic blood pressure decreased significantly over 1 year, notably at 9 months (131 mm Hg, β9=3.244, P<.001), and continued up to 12 months (131.6mm Hg, β12=2.827, P<.001). In addition, a higher frequency of completed measurements was associated with better systolic blood pressure control at 3, 6, 9, and 12 months (β3=-0.016, P=.002; β6=-0.006, P=.02; β9=-0.002, P=.44; β12=-0.003, P=.02). These results remained significant even after accounting for age, sex, and comorbidity status.
This study, using LGCMs and repeated measures data, revealed a significant positive impact of patient engagement on long-term blood pressure control in mHealth interventions targeting older individuals with hypertension. These findings stress the importance of integration of patient-centered engagement approach into mHealth programs designed for chronic disease management in aging populations.
仅有有限的研究探讨了患者参与度对移动健康（mHealth）干预措施长期效果的影响，尤其是在老年人中。
本研究旨在通过在5个预设时间点重复测量患者参与度和结果，考察社交媒体驱动的移动健康干预措施对中国老年高血压患者血压控制的长期影响。
该研究纳入了2017年至2022年间的中国老年高血压患者。参与者通过微信社交媒体应用程序（腾讯控股有限公司）接受了高血压自我管理项目，该项目提供基于临床的数字指导。在基线、3个月、6个月、9个月和12个月时，使用连接到该应用程序的家用血压监测仪（HBPM）反复测量血压。根据相应随访中完成测量的频率评估患者参与度。潜在增长曲线模型（LGCMs）用于评估患者参与度对预设时间点的老年高血压患者血压的影响。
共有1723名患者完成了12个月的随访（平均年龄70.1岁，标准差6.8岁；890/1723，51.7%为女性；基线收缩压137.2 mmHg）。LGCMs显示，收缩压在1年内显著下降，尤其是在9个月时（131 mmHg，β9=3.244，P<0.001），并持续到12个月（131.6 mmHg，β12=2.827，P<0.001）。此外，在3个月、6个月、9个月和12个月时，完成测量的频率越高，收缩压控制越好（β3=-0.016，P=0.002；β6=-0.006，P=0.02；β9=-0.002，P=0.44；β12=-0.003，P=0.02）。即使在考虑了年龄、性别和合并症状态后，这些结果仍然显著。
本研究使用LGCMs和重复测量数据，揭示了患者参与度对针对老年高血压患者的移动健康干预措施中血压长期控制具有显著的积极影响。这些发现强调了将以患者为中心的参与方法纳入为老年人群慢性病管理设计的移动健康项目中的重要性。
