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 .
Telemedicine cardiovascular risk reduction in veterans: The CITIES trial
Background : Comprehensive programs addressing tailored patient self‐management and pharmacotherapy may reduce barriers to cardiovascular disease ( CVD ) risk reduction . Methods : This is a 2‐arm ( clinical pharmacist specialist – delivered , telehealth intervention and education control ) r and omized controlled trial including Veterans with poorly controlled hypertension and /or hypercholesterolemia . Primary outcome was Framingham CVD risk score at 6 and 12 months , with systolic blood pressure ; diastolic blood pressure ; total cholesterol ; low‐density lipoprotein ; high‐density lipoprotein ; body mass index ; and , for those with diabetes , HbA1c as secondary outcomes . Results : Among 428 Veterans , 50 % were African American , 85 % were men , and 33 % had limited health literacy . Relative to the education control group , the clinical pharmacist specialist – delivered intervention did not show a reduction in CVD risk score at 6 months ( −1.8 , 95 % CI −3.9 to 0.3 ; P = .10 ) or 12 months ( −0.3 , 95 % CI −2.4 to 1.7 ; P = .74 ) . No differences were seen in systolic blood pressure , diastolic blood pressure , or low‐density lipoprotein at 6 or 12 months . We did observe a significant decline in total cholesterol at 6 months ( −7.0 , 95 % CI −13.4 to −0.6 ; P = .03 ) in the intervention relative to education control group . Among patients in the intervention group , 34 % received at least 5 of the 12 planned intervention calls and were considered “ compliers . ” A sensitivity analysis of the “ complier average causal effect ” of intervention compared to control showed a mean difference in CVD risk score reduction of 5.7 ( 95 % CI −12.0 to 0.7 ) at 6 months and −1.7 ( 95 % CI −7.6 to 4.8 ) at 12 months . Conclusions : Despite increased access to pharmacist re sources , we did not observe significant improvements in CVD risk for patients r and omized to the intervention compared to education control over 12 months . However , the intervention may have positive impact among those who actively participate , particularly in the short term
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 .