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 .
Structured Caregiver Feedback Enhances Engagement and Impact of Mobile Health Support: A Randomized Trial in a Lower-Middle-Income Country.
BACKGROUND Patients ' engagement in mobile health ( m-health ) interventions using interactive voice response ( IVR ) calls is less in low- and middle-income countries ( LMICs ) than in industrialized ones . We conducted a study to determine whether automated telephone feedback to informal caregivers ( " CarePartners " ) increased engagement in m-health support among diabetes and hypertension patients in Bolivia . MATERIAL S AND METHODS Patients with diabetes and /or hypertension were identified through ambulatory clinics affiliated with four hospitals . All patients enrolled with a CarePartner . Patients were r and omized to weekly IVR calls including self-management questions and self-care education either alone ( " st and ard m-health " ) or with automated feedback about health and self-care needs sent to their CarePartner after each IVR call ( " m-health+CP " ) . RESULTS The 72 participants included 39 with diabetes and 53 with hypertension , of whom 19 had ≤6 years of education . After 1,225 patient-weeks of attempted IVR assessment s , the call completion rate was higher among patients r and omized to m-health+CP compared with st and ard m-health ( 62.0 % versus 44.9 % ; p < 0.047 ) . CarePartner feedback more than tripled call completion rates among indigenous patients and patients with low literacy ( p < 0.001 for both ) . M-health+CP patients were more likely to report excellent health via IVR ( adjusted odds ratio [ AOR ] = 2.60 ; 95 % confidence interval [ CI ] , 1.07 , 6.32 ) and less likely to report days in bed due to illness ( AOR = 0.42 ; 95 % CI , 0.19 , 0.91 ) . CONCLUSIONS In this study we found that caregiver feedback increased engagement in m-health and may improve patients ' health status relative to st and ard approaches . M-health+CP represents a scalable strategy for increasing the reach of self-management support in LMICs
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 .