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 .
Home blood pressure monitoring, secure electronic messaging and medication intensification for improving hypertension control: a mediation analysis.
OBJECTIVE We evaluated the role of home monitoring , communication with pharmacists , medication intensification , medication adherence and lifestyle factors in contributing to the effectiveness of an intervention to improve blood pressure control in patients with uncontrolled essential hypertension . METHODS We performed a mediation analysis of a published r and omized trial based on the Chronic Care Model delivered over a secure patient website from June 2005 to December 2007 . Study arms analyzed included  usual care with a home blood pressure monitor and usual care with home blood pressure monitor and web-based pharmacist care . Mediator measures included secure messaging and telephone encounters ; home blood pressure monitoring ; medications intensification and adherence and lifestyle factors . Overall fidelity to the Chronic Care Model was assessed with the Patient Assessment of Chronic Care ( PACIC ) instrument . The primary outcome was percent of participants with blood pressure ( BP ) < 140/90 mm Hg . RESULTS At 12 months follow-up , patients in the  web-based pharmacist care group were more likely to have BP < 140/90 mm Hg ( 55 % ) compared to patients in the group with home blood pressure monitors only ( 37 % ) ( p = 0.001 ) . Home blood pressure monitoring accounted for 30.3 % of the intervention effect , secure electronic messaging accounted for 96 % , and medication intensification for 29.3 % . Medication adherence and self-report of fruit and vegetable intake and weight change were not different between the two study groups . The PACIC score accounted for 22.0 % of the main intervention effect . CONCLUSIONS The effect of web-based pharmacist care on improved blood pressure control was explained in part through a combination of home blood pressure monitoring , secure messaging , and antihypertensive medication intensification
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 .