Background

Increasingly, health professionals and patients have begun to be involved in eHealth interventions to assist in the self-management of hypertension. Therefore, this study was aimed at comparing the effect of different types of eHealth interventions (phone calls, blood pressure telemonitoring, emails, web-site, smartphone-app, short message service (SMS) and more than two eHealth interventions) on reducing systolic and diastolic blood pressure, increasing adherence to medication treatment, improving physical activity compliance, controlling blood pressure, and improving quality of life (QoL).

Methods

A systematic search in MEDLINE (via PubMed), EMBASE, Cochrane Central Register of Controlled Trials, and Web of Science databases was conducted to identify experimental studies addressing the effect of eHealth interventions on the self-management of hypertension. Comparative evaluation of the eHealth interventions effect were performed by conducting a standard pairwise meta-analysis and a network meta-analysis for direct and indirect comparisons between eHealth interventions and control/non-intervention.

Results

Fifty-one studies were included in the analysis showing a moderate effect size for more than two types of eHealth interventions (-0.46; 95%CI: -0.64, -0.27, p < 0.001 and -0.29; 95%CI: -0.46, -0.13, p < 0.001), phone calls (-0.37; 95%CI: -0.57, -0.17, p < 0.001 and -0.29; 95%CI: -0.52, -0.07, p = 0.011) and smartphone-app (-0.26; 95%CI: -0.50, -0.01, p = 0.040 and -0.40; 95%CI: -0.70, -0.10, p = 0.010) on reducing both systolic and diastolic blood pressure, respectively. Additionally, i) smartphone-app improved medication adherence by 45%; ii) more than two types of eHealth interventions and emails improved physical activity compliance by 18% and 57% respectively; ii) more than two types of eHealth interventions, phone calls, blood pressure telemonitoring, website and SMS improved blood pressure control between 16% and 30%; and iv) blood pressure telemonitoring showed a week effect on QoL

Conclusions

Our study reported eHealth to be a suitable intervention for the self-management of hypertension. Considering our results and the population's accessibility to eHealth devices, eHealth could be a useful and largely scalable tool for the self-management of hypertension.

Systematic review registration

PROSPERO CRD42020187468.

中文翻译：

---

电子健康干预对高血压管理相关结果的比较影响：网络荟萃分析

背景

越来越多的卫生专业人员和患者开始参与电子卫生干预，以协助高血压的自我管理。因此，本研究旨在比较不同类型的电子健康干预措施（电话、血压远程监测、电子邮件、网站、智能手机应用程序、短信服务 (SMS) 和两种以上电子健康干预措施）对减少收缩压的影响。和舒张压、增加对药物治疗的依从性、提高身体活动依从性、控制血压和改善生活质量 (QoL)。

方法

在 MEDLINE（通过 PubMed）、EMBASE、Cochrane Central Register of Controlled Trials 和 Web of Science 数据库中进行了系统搜索，以确定解决电子健康干预对高血压自我管理影响的实验研究。通过进行标准的成对荟萃分析和网络荟萃分析，对电子健康干预措施和控制/非干预之间的直接和间接比较进行了电子健康干预效果的比较评估。

结果

分析中纳入了 51 项研究，显示超过两种类型的电子卫生干预措施的效果中等（-0.46；95%CI：-0.64，-0.27，p < 0.001 和 -0.29；95%CI：-0.46， -0.13，p < 0.001），电话（-0.37；95%CI：-0.57，-0.17，p < 0.001 和 -0.29；95%CI：-0.52，-0.07，p  = 0.011）和智能手机应用程序（ -0.26；95%CI：-0.50，-0.01，p  = 0.040 和 -0.40；95%CI：-0.70，-0.10，p = 0.010) 分别降低收缩压和舒张压。此外，i) 智能手机应用程序将药物依从性提高了 45%；ii) 两种以上的电子健康干预措施和电子邮件分别将身体活动依从性提高了 18% 和 57%；ii) 两种以上的电子健康干预措施、电话、血压远程监测、网站和短信将血压控制提高了 16% 到 30%；iv) 血压远程监测显示一周对 QoL 的影响

结论

我们的研究报告称，电子健康是高血压自我管理的合适干预措施。考虑到我们的结果和人们对 eHealth 设备的可及性，eHealth 可能是高血压自我管理的有用且可大规模扩展的工具。

系统评价注册

PROSPERO CRD42020187468。