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 .
A randomized controlled trial of positive-affect intervention and medication adherence in hypertensive African Americans.
BACKGROUND Poor adherence explains poor blood pressure ( BP ) control ; however African Americans suffer worse hypertension-related outcomes . METHODS This r and omized controlled trial evaluated whether a patient education intervention enhanced with positive-affect induction and self-affirmation ( PA ) was more effective than patient education ( PE ) alone in improving medication adherence and BP reduction among 256 hypertensive African Americans followed up in 2 primary care practice s. Patients in both groups received a culturally tailored hypertension self-management workbook , a behavioral contract , and bimonthly telephone calls design ed to help them overcome barriers to medication adherence . Also , patients in the PA group received small gifts and bimonthly telephone calls to help them incorporate positive thoughts into their daily routine and foster self-affirmation . The main outcome measures were medication adherence ( assessed with electronic pill monitors ) and within-patient change in BP from baseline to 12 months . RESULTS The baseline characteristics were similar in both groups : the  mean BP was 137/82 mm Hg ; 36 % of the patients had diabetes ; 11 % had stroke ; and 3 % had chronic kidney disease . Based on the intention-to-treat principle , medication adherence at 12 months was higher in the PA group than in the PE group ( 42 % vs 36 % , respectively ; P = .049 ) . The within-group reduction in systolic BP ( 2.14 mm Hg vs 2.18 mm Hg ; P = .98 ) and diastolic BP ( -1.59 mm Hg vs -0.78 mm Hg ; P = .45 ) for the PA group and PE group , respectively , was not significant . CONCLUSIONS A PE intervention enhanced with PA led to significantly higher medication adherence compared with PE alone in hypertensive African Americans . Future studies should assess the cost-effectiveness of integrating such interventions into primary care . Trial Registration clinical trials.gov Identifier : NCT00227175
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 .