The most commonly described determinants at the patient level were lack of education , lack of self-awareness , lack of self-efficacy , and forgetfulness .
Clinical inertia and an inadequate health workforce were the most commonly targeted determinants at the health care team and system level .
Taking medication , interactive patient-provider communication , self-measurement , and lifestyle management were the most cited patient behaviors at both levels .
Most of the DIs did not include support from peers or family members , despite its reported effectiveness and the rate of social media penetration .
Background Information on how behavior change strategies have been used to design digital interventions ( DIs ) to improve blood pressure ( BP ) control or medication adherence ( MA ) for patients with hypertension is currently limited .
Objective Hypertension is a major modifiable risk factor for cardiovascular diseases and can be controlled with appropriate medication .
Many interventions that target MA to improve BP are increasingly using modern digital technologies .
This systematic review was conducted to discover how DIs have been design ed to improve MA and BP control among patients with hypertension in the recent 10 years .
The Influence of Wireless Self-Monitoring Program on the Relationship Between Patient Activation and Health Behaviors, Medication Adherence, and Blood Pressure Levels in Hypertensive Patients: A Substudy of a Randomized Controlled Trial
Background Active engagement in the management of hypertension is important in improving self-management behaviors and clinical outcomes . Mobile phone technology using wireless monitoring tools are now widely available to help individuals monitor their blood pressure , but little is known about the conditions under which such technology can effect positive behavior changes or clinical outcomes . Objective To study the influence of wireless self-monitoring program and patient activation measures on health behaviors , medication adherence , and blood pressure levels as well as control of blood pressure in hypertensive patients . Methods We examined a subset of 95 hypertensive participants from a 6-month r and omized controlled trial design ed to determine the utility of a  wireless self-monitoring program ( n=52 monitoring program , n=43 control ) , which consisted of a blood pressure monitoring device connected with a mobile phone , reminders for self-monitoring , a Web-based disease management program , and a mobile app for monitoring and education , compared with the control group receiving a st and ard disease management program . Study participants provided measures of patient activation , health behaviors including smoking , drinking , and exercise , medication adherence , and blood pressure levels . We assessed the influence of wireless self-monitoring as a moderator of the relationship between patient activation and health behaviors , medication adherence , and control of blood pressure . Results Improvements in patient activation were associated with improvements in cigarette smoking ( beta=−0.46 , P<.001 ) and blood pressure control ( beta=0.04 , P=.02 ) . This relationship was further strengthened in reducing cigarettes ( beta=−0.60 , P<.001 ) , alcohol drinking ( beta=−0.26 , P=.01 ) , and systolic ( beta=−0.27 , P=.02 ) and diastolic blood pressure ( beta=−0.34 , P=.007 ) at 6 months among individuals participating in the wireless self-monitoring program . No differences were observed with respect to medication adherence . Conclusions Participation in a wireless self-monitoring program provides individuals motivated to improve their health management with an added benefit above and beyond that of motivation alone . Hypertensive individuals eager to change health behaviors are excellent c and i date s for mobile health self-monitoring .. Trial Registration Clinical Trials.gov NCT01975428 , https:// clinical trials.gov/ct2/show/NCT01975428 ( Archived by WebCite at http://www.webcitation.org/6iSO5OgOG
The most commonly described determinants at the patient level were lack of education , lack of self-awareness , lack of self-efficacy , and forgetfulness .
Clinical inertia and an inadequate health workforce were the most commonly targeted determinants at the health care team and system level .
Taking medication , interactive patient-provider communication , self-measurement , and lifestyle management were the most cited patient behaviors at both levels .
Most of the DIs did not include support from peers or family members , despite its reported effectiveness and the rate of social media penetration .
Background Information on how behavior change strategies have been used to design digital interventions ( DIs ) to improve blood pressure ( BP ) control or medication adherence ( MA ) for patients with hypertension is currently limited .
Objective Hypertension is a major modifiable risk factor for cardiovascular diseases and can be controlled with appropriate medication .
Many interventions that target MA to improve BP are increasingly using modern digital technologies .
This systematic review was conducted to discover how DIs have been design ed to improve MA and BP control among patients with hypertension in the recent 10 years .