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Meta-Analysis
. 2021 Mar 26;3(3):CD012675.
doi: 10.1002/14651858.CD012675.pub3.

Mobile phone-based interventions for improving adherence to medication prescribed for the primary prevention of cardiovascular disease in adults

Melissa J Palmer  1 , Kazuyo Machiyama  1 , Susannah Woodd  1 , Anasztazia Gubijev  1 , Sharmani Barnard  2 , Sophie Russell  3 , Pablo Perel  1 , Caroline Free  1
Affiliations
Meta-Analysis

Mobile phone-based interventions for improving adherence to medication prescribed for the primary prevention of cardiovascular disease in adults

Melissa J Palmer et al. Cochrane Database Syst Rev. .

Abstract

Background: Cardiovascular disease (CVD) is a major cause of disability and mortality globally. Premature fatal and non-fatal CVD is considered to be largely preventable through the control of risk factors by lifestyle modifications and preventive medication. Lipid-lowering and antihypertensive drug therapies for primary prevention are cost-effective in reducing CVD morbidity and mortality among high-risk people and are recommended by international guidelines. However, adherence to medication prescribed for the prevention of CVD can be poor. Approximately 9% of CVD cases in the EU are attributed to poor adherence to vascular medications. Low-cost, scalable interventions to improve adherence to medications for the primary prevention of CVD have potential to reduce morbidity, mortality and healthcare costs associated with CVD.

Objectives: To establish the effectiveness of interventions delivered by mobile phone to improve adherence to medication prescribed for the primary prevention of CVD in adults.

Search methods: We searched CENTRAL, MEDLINE, Embase, and two other databases on 7 January 2020. We also searched two clinical trials registers on 5 February 2020. We searched reference lists of relevant papers. We applied no language or date restrictions.

Selection criteria: We included randomised controlled trials investigating interventions delivered wholly or partly by mobile phones to improve adherence to cardiovascular medications prescribed for the primary prevention of CVD. We only included trials with a minimum of one-year follow-up in order that the outcome measures related to longer-term, sustained medication adherence behaviours and outcomes. Eligible comparators were usual care or control groups receiving no mobile phone-delivered component of the intervention.

Data collection and analysis: We used standard methodological procedures recommended by Cochrane. The main outcomes of interest were objective measures of medication adherence (blood pressure (BP) and cholesterol), CVD events, and adverse events. We contacted study authors for further information when this was not reported.

Main results: We included 14 trials with 25,633 randomised participants. Participants were recruited from community-based primary and tertiary care or outpatient clinics. The interventions varied widely from those delivered solely through short messaging service (SMS) to those involving a combination of modes of delivery, such as SMS in addition to healthcare worker training, face-to-face counselling, electronic pillboxes, written materials, and home blood pressure monitors. Some interventions only targeted medication adherence, while others additionally targeted lifestyle changes such as diet and exercise. Due to heterogeneity in the nature and delivery of the interventions and study populations, we reported most results narratively, with the exception of two trials which were similar enough to meaningfully pool in meta-analyses. The body of evidence for the effect of mobile phone-based interventions on objective outcomes of adherence (BP and cholesterol) was of low certainty, due to most trials being at high risk of bias, and inconsistency in outcome effects. Two trials were at low risk of bias. Among five trials (total study enrolment: 5441 participants) recording low-density lipoprotein cholesterol (LDL-C), two studies found evidence for a small beneficial intervention effect on reducing LDL-C (-5.30 mg/dL, 95% confidence interval (CI) -8.30 to -2.30; and -9.20 mg/dL, 95% CI -17.70 to -0.70). The other three studies found results varying from a small reduction (-7.7 mg/dL) to a small increase in LDL-C (0.77 mg/dL). All of which had wide confidence intervals that included no effect. Across 13 studies (25,166 participants) measuring systolic blood pressure, effect estimates ranged from a large reduction (MD -12.45 mmHg, 95% CI -15.02 to -9.88) to a small increase (MD 2.80 mmHg, 95% CI 0.30 to 5.30). We found a similar range of effect estimates for diastolic BP, ranging from -12.23 mmHg (95% CI 14.03 to -10.43) to 1.64 mmHg (95% CI -0.55 to 3.83) (11 trials, 19,716 participants). Four trials showed intervention benefits for systolic and diastolic BP with confidence intervals excluding no effect, and among these were all three of the trials evaluating self-monitoring of blood pressure with mobile phone-based telemedicine. The fourth trial included SMS and provider support (with additional varied features). Seven studies (19,185 participants) reported 'controlled' BP as an outcome, and intervention effect estimates varied from negligible effects (odds ratio (OR) 1.01, 95% CI 0.76 to 1.34) to large improvements in BP control (OR 2.41, 95% CI: 1.57 to 3.68). The three trials of clinician training or decision support combined with SMS (with additional varied features) had confidence intervals encompassing benefits and harms, with point estimates close to zero. Pooled analyses of the two trials of interventions solely delivered through SMS were indicative of little or no beneficial intervention effect on systolic BP (MD -1.55 mmHg, 95% CI -3.36 to 0.25; I2 = 0%) and small increases in controlled BP (OR 1.32, 95% CI 1.06 to 1.65; I2 = 0%). Based on four studies (12,439 participants), there was very low-certainty evidence (downgraded twice for imprecision and once for risk of bias) relating to the intervention effect on combined (fatal and non-fatal) CVD events. Two studies (2535 participants) provided low-certainty evidence for the effect of the intervention on cognitive outcomes, with little or no difference between trial arms for perceived quality of care and satisfaction with treatment. There was moderate-certainty evidence (downgraded due to risk of bias) that the interventions did not cause harm, based on six studies (8285 participants). Three studies reported no adverse events attributable to the intervention. One study reported no difference between groups in experience of adverse effects of statins, and that no participants reported intervention-related adverse events. One study stated that potential side effects were similar between groups. One study reported a similar number of deaths in each arm, but did not provide further information relating to potential adverse events.

Authors' conclusions: There is low-certainty evidence on the effects of mobile phone-delivered interventions to increase adherence to medication prescribed for the primary prevention of CVD. Trials of BP self-monitoring with mobile-phone telemedicine support reported modest benefits. One trial at low risk of bias reported modest reductions in LDL cholesterol but no benefits for BP. There is moderate-certainty evidence that these interventions do not result in harm. Further trials of these interventions are warranted.

Trial registration: ClinicalTrials.gov NCT01834131 NCT03580330 NCT02913339 NCT01142908 NCT04120779 NCT03105687 NCT01890018 NCT04066010 NCT03515083 NCT03515681 NCT03872856 NCT03986931 NCT04076020 NCT04259489 NCT04409210 NCT03317951 NCT02377960 NCT03397849.

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Conflict of interest statement

MP: none known.

SB: none known.

PP: none known.

CF: none known.

SW: none known.

KM: none known.

AG: none known.

SR: none known.

Figures

1
1
Study flow diagram.
2
2
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
1.1
1.1. Analysis
Comparison 1: Mobile phone intervention versus control, Outcome 1: Change in low‐density lipoprotein cholesterol (mg/dL)
1.2
1.2. Analysis
Comparison 1: Mobile phone intervention versus control, Outcome 2: Change in total cholesterol (mg/dL)
1.3
1.3. Analysis
Comparison 1: Mobile phone intervention versus control, Outcome 3: Change in high‐density lipoprotein cholesterol (mg/dL)
1.4
1.4. Analysis
Comparison 1: Mobile phone intervention versus control, Outcome 4: Change in systolic blood pressure (mmHg)
1.5
1.5. Analysis
Comparison 1: Mobile phone intervention versus control, Outcome 5: Pooled change in systolic blood pressure (mmHg)
1.6
1.6. Analysis
Comparison 1: Mobile phone intervention versus control, Outcome 6: Change in diastolic blood pressure (mmHg)
1.7
1.7. Analysis
Comparison 1: Mobile phone intervention versus control, Outcome 7: Controlled blood pressure
1.8
1.8. Analysis
Comparison 1: Mobile phone intervention versus control, Outcome 8: Pooled controlled blood pressure
1.9
1.9. Analysis
Comparison 1: Mobile phone intervention versus control, Outcome 9: Combined fatal and non‐fatal CVD events
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Update of

Comment in

References

References to studies included in this review

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Beratarrechea 2019 {published data only}
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    1. NCT04066010. Optimizing the approach of mobile application use to improve medication adherence in patients with hypertension. clinicaltrials.gov/ct2/show/NCT04066010 (first received 22 August 2019).
Neafsey 2011 {published data only}
    1. Neafsey PJ, M'lan CE, Ge M, Walsh SJ, Lin CA, Anderson E. Reducing adverse self-medication behaviors in older adults with hypertension: results of an e-health clinical efficacy trial. Ageing International 2011;36(2):159-91. [DOI: 10.1007/s12126-010-9085-9] - DOI - PMC - PubMed
O'Connor 2014 {published data only}
    1. O'Connor PJ, Schmittdiel JA, Pathak RD, Harris RI, Newton KM, Ohnsorg KA, et al. Randomized trial of telephone outreach to improve medication adherence and metabolic control in adults with diabetes. Diabetes Care 2014;37(12):3317-24. [DOI: 10.2337/dc14-0596] - DOI - PMC - PubMed
Olorun 2014 {published data only}
    1. Olorun OJ, Afolabi MO, Oyebisi TO, Ogunsina AO, Akintomide AO, Adebayo RA. Exploring medicine information needs of hypertensive patients using short message service. British Journal of Medicine & Medical Research 2014;4(34):5368-80.
Parati 2013 {published data only}
    1. Parati G, Omboni S, Compare A, Grossi E, Callus E, Venco A, et al. Blood pressure control and treatment adherence in hypertensive patients with metabolic syndrome: protocol of a randomized controlled study based on home blood pressure telemonitoring vs. conventional management and assessment of psychological determinants of adherence (TELEBPMET Study). Trials 2013;14:22. [DOI: 10.1186/1745-6215-14-22] - DOI - PMC - PubMed
Richard 2016 {published data only}
    1. Richard E, Jongstra S, Soininen H, Brayne C, Moll van Charante EP, Meiller Y, et al. Healthy Ageing Through Internet Counselling in the Elderly: the HATICE randomised controlled trial for the prevention of cardiovascular disease and cognitive impairment. BMJ Open 2016;6(6):e010806. [DOI: 10.1136/bmjopen-2015-010806] - DOI - PMC - PubMed
Salisbury 2016 {published data only}
    1. Salisbury C, O'Cathain A, Thomas C, Edwards L, Gaunt D, Dixon P, et al. Telehealth for patients at high risk of cardiovascular disease: pragmatic randomised controlled trial. BMJ 2016;353:i2647. [DOI: 10.1136/bmj.i2647] - DOI - PMC - PubMed
    1. Thomas CL, Man MS, O'Cathain A, Hollinghurst S, Large S, Edwards L, et al. Effectiveness and cost-effectiveness of a telehealth intervention to support the management of long-term conditions: study protocol for two linked randomized controlled trials. Trials 2014;24(15):36. [DOI: 10.1186/1745-6215-15-36] - DOI - PMC - PubMed
Ueda 2017 {published data only}
    1. Ueda K, Kashiba A, Ooue C, Kimura A, Takeshita T, Arita M. Effects of a home blood pressure monitoring by mobile phone-based self-management support system in mild hypertension: the Katsuragi study. Journal of Hypertension 2017;35(Suppl 2):e56-7.
Vollmer 2014 {published data only}
    1. Vollmer WM, Owen-Smith AA, Tom JO, Laws R, Ditmer DG, Smith DH, et al. Improving adherence to cardiovascular disease medications with information technology. American Journal of Managed Care 2014;20(11 Spec No. 17):SP502-10. - PMC - PubMed
Wakefield 2011 {published data only}
    1. Wakefield BJ, Holman JE, Ray A, Scherubel M, Adams MR, Hillis SL, et al. Effectiveness of home telehealth in comorbid diabetes and hypertension: a randomized, controlled trial. Telemedicine and e-Health 2011;17(4):254-61. [DOI: 10.1089/tmj.2010.0176] - DOI - PubMed
Wald 2014 {published data only}
    1. Wald DS, Bestwick JP, Raiman L, Brendell R, Wald NJ. Randomised trial of text messaging on adherence to cardiovascular preventive treatment (INTERACT trial). PLOS One 2014;9(12):e114268. [DOI: 10.1371/journal.pone.0114268] - DOI - PMC - PubMed
Warren 2012 {published data only}
    1. Warren J, Kennelly J, Warren D, Elley CR, Wai KC, Manukia M, et al. Using the general practice EMR for improving blood pressure medication adherence. Studies in Health Technology and Informatics 2012;178:228-34. [DOI: 10.3233/978-1-61499-078-9-228] - DOI - PubMed
Wittig‐Wells 2019 {published data only}
    1. Wittig-Wells D, Higgins M, Carter J, Davis E, Holmes E, Jacob A, et al. Impact of a preset daily cell phone alarm on medication adherence for aspirin as antithrombotic therapy. Orthopaedic Nursing 2019;38(5):311-6. - PubMed
Yatabe 2018 {published data only}
    1. Yatabe MS, Yatabe J, Asayama K, Staessen JA, Mujaj B, Thijs L, et al. The rationale and design of reduction of uncontrolled hypertension by Remote Monitoring and Telemedicine (REMOTE) study. Blood Pressure 2018;27(2):99-105. - PubMed
Zhechun 2018 {published data only}
    1. Zhechun Z, Wang J, Su J, Zuo H, Wu Z. The rationale, design, and baseline characteristics of BP-CONNECT: a community-based multi-center open-labeled randomized controlled trial of mobile internet-and social media-based case management strategy to control hypertension in China. Journal of Hypertension 2018;36:e293-4.

References to studies awaiting assessment

ACTRN12614000956606 {published data only}
    1. ACTRN12614000956606. Randomized trial in patients with diabetes in Curacavi, Chile: can MiDoctor improve glycemic control in comparison to usual care? anzctr.org.au/ACTRN12614000956606 (first received 8 September 2014).
ACTRN12617001285347 {published data only}
    1. ACTRN12617001285347. A randomized controlled trial to determine the efficacy of Perx, an iPhone application for promoting medication adherence [A randomized controlled trial to determine the efficacy of Perx, an iPhone application for promoting medication adherence among sufferers of chronic disease]. anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373536 (first received 6 September 2017).
ChiCTR1800017829 {published data only}
    1. ChiCTR1800017829. Smartphone APP for real-time blood pressure monitor and control trial. chictr.org.cn/hvshowproject.aspx?id=17815 (first received 19 October 2018). [ChiCTR1800017829]
ChiCTR1900026862 {published data only}
    1. ChiCTR1900026862. Efficacy of text messages and personal consultation by pharmacy students for adults with hypertension: a randomized controlled trial. chictr.org.cn/showproj.aspx?proj=42717 (first received 2019).
ChiCTR2000030677 {published data only}
    1. ChiCTR2000030677. An internet-based patient- primary care physician-cardiologist integrated management model of hypertension in China: a multicenter randomized controlled trial [An internet-based patient- primary care physician-cardiologist integrated management model of hypertension in China]. chictr.org.cn/showproj.aspx?proj=48887 (first posted 3 September 2020). - PMC - PubMed
ChiCTR2000034579 {published data only}
    1. ChiCTR2000034579. Effects of mobile health interventions on population with high risk of cardiovascular metabolic diseases: a randomized controlled trial. Evaluation of the effects of interventions based on mobile health on population with high risk of cardiovascular metabolic diseases: a randomized controlled trial (first received 11 July 2020).
ChiCTR‐IOR‐17013599 {published data only}
    1. ChiCTR‐IOR‐17013599. A community-based multi-center comparative effectiveness randomized controlled trial of mobile internet- and social media-based intervention and telemonitoring with self-management for control of blood pressure in China. who.int/trialsearch/Trial2.aspx?TrialID=ChiCTR-IOR-17013599 (first received 2017).
ChiCTR‐IOR‐17014227 {published data only}
    1. ChiCTR-IOR-17014227. The effectiveness of a mobile application enhanced nurse-led intervention program on hypertension control and self-care promotion in Chinese hypertensive patients. chictr.org.cn/showproj.aspx?proj=23692 (first received 30 December 2017). [ChiCTR-IOR-17014227]
CTRI/2017/09/009710 {published data only}
    1. CTRI/2017/09/009710. Effectiveness of mobile health (mHealth) intervention programme (mHealth-MS) on Metabolic Syndrome. who.int/trialsearch/Trial2.aspx?TrialID=CTRI/2017/09/009710 (first received 2017).
CTRI/2018/10/015962 {published data only}
    1. CTRI/2018/10/015962. A trial to study the effectiveness of multi component behavioural intervention programme on medication compliance and quality of life among elderly with chronic illness [A community based randomized controlled trial (RCT) to determine the efficiency of multi-component behavioral intervention programme (MBIP) on medication compliance and quality of life among elderly with chronic illness residing in selected rural areas of Udupi district, Karnataka]. ctri.nic.in/CTRI/2018/10/015962 (first received 9 October 2018).
DRKS00019022 {published data only}
    1. DRKS00019022. HITS heart failure individual training telemonitoring and self managment. drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00... (first posted 28 May 2020).
ISRCTN10999269 {published data only}ISRCTN10999269
    1. ISRCTN10999269. Personalized management of high blood pressure in Anhui, China. isrctn.com/ISRCTN10999269 (first posted 17 July 2020).
ISRCTN15952379 {published data only}ISRCTN15952379
    1. ISRCTN15952379. Support through mobile messaging and digital health technology for diabetes [Supporting people with type 2 diabetes in effective use of their medicine through a system comprising mobile health technology integrated with clinical care compared with usual care: a randomised controlled trial]. isrctn.com/ISRCTN15952379 (first posted 18 September 2020).
ISRCTN82013652 {published data only}ISRCTN82013652
    1. ISRCTN82013652. Programme on adherence to medication [Programme on Adherence to Medication (PAM): a very brief nurse-led intervention, followed by a text message or a smartphone app to support medication adherence in people prescribed treatment for hypertension in primary care. A randomised controlled trial]. isrctn.com/ISRCTN82013652 (first posted 9 December 2019).
Jia 2020 {published data only}
    1. Jia W, Zhang P, Duolikun N, Zhu D, Li H, Bao Y, et al. Study protocol for the road to hierarchical diabetes management at primary care (ROADMAP) study in China: a cluster randomised controlled trial. BMJ Open 2020;10(1):e032734. [DOI: ] - PMC - PubMed
JPRN‐UMIN000025372 {published data only}
    1. JPRN‐UMIN000025372. Comparison of antihypertensive medical care using telemedicine vs. conventional therapy. upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000029170 (first received 14 June 2016). [JPRN‐UMIN000025372]
JPRN‐UMIN000035898 {published data only}
    1. JPRN‐UMIN000035898. Effects of smartphone application-based integrated self-care support system for hypertensive patients. upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000040740 (first received 17 February 2019). [UMIN000035898]
JPRN‐UMIN000038029 {published data only}
    1. JPRN-UMIN000038029. Community mHealth integrated care (ComHIC) to manage hypertension/diabetes in Tanzania's overburdened health system. umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000043357 (first posted 18 September 2019).
LoGerfo 2019 {published data only}
    1. LoGerfo JP, Fitzpatrick AL, Pelt M, Heang H, Steinman L, Ide N, et al. Using targeted mHealth messages to address hypertension and diabetes self-management in Cambodia: protocol for a clustered randomized controlled trial. JMIR Research Protocols 2019;8(3):e11614. - PMC - PubMed
Luong 2019 {published data only}
    1. Luong P, Waughtal J, Glorioso TJ, Caputo Sandy LM, Ho M, Peterson P et al. Text message medication adherence reminders automated and delivered at scale across two institutions: pilot testing the “Nudge” system. Circulation 2019;140(Suppl 1):A12910. - PMC - PubMed
Meurer 2020 {published data only}
    1. Meurer WJ, Dinh M, Kidwell KM, Flood A, Champoux E, Whitfield C, et al. Reach out behavioral intervention for hypertension initiated in the emergency department connecting multiple health systems: study protocol for a randomized control trial. Trials 2020;21:1-16. - PMC - PubMed
NCT03515083 {published data only}
    1. NCT03515083. Better outcomes for anticoagulation treatment through observation of atrial rhythm (BOAT OAR). clinicaltrials.gov/ct2/show/NCT03515083 (first received 3 May 2018).
NCT03515681 {published data only}
    1. NCT03515681. Retail outlet health kiosk hypertension trial (ROKHyT). clinicaltrials.gov/ct2/show/study/NCT03515681 (first received 3 May 2018).
NCT03872856 {published data only}
    1. NCT03872856. Blood pressure-improving control among Alaska native people (BP-ICAN) (CHAR2) [Home blood pressure monitoring intervention for self-management of high blood pressure among Alaska native people]. clinicaltrials.gov/ct2/show/NCT03872856 (first received 13 March 2019).
NCT03986931 {published data only}
    1. NCT03986931. A pharmacist intervention for monitoring and treating hypertension using bidirectional texting. clinicaltrials.gov/ct2/show/NCT03986931 (first received 14 June 2019). [NCT03986931]
NCT04076020 {published data only}
    1. NCT04076020. Atrial fibrillation health literacy and information technology trial in rural PA counties (AFibLITT_R). clinicaltrials.gov/ct2/show/NCT04076020 (first received 3 September 2019).
NCT04259489 {published data only}
    1. NCT04259489. Effectiveness of SCDM in patients with type 2 diabetes (ESCDM) [Effectiveness of share care diabetes management in patients with type 2 diabetes]. clinicaltrials.gov/ct2/show/NCT04259489 (first posted 6 February 2020).
NCT04409210 {published data only}
    1. NCT04409210. Cardio-cerebrovascular co-prevention and co-management based on internet+ (DEMO-CoCo) [Development, demonstration and evaluation of model of cardiovascular and cerebrovascular "co-prevention and co-management" based on internet+]. clinicaltrials.gov/ct2/show/NCT04409210 (first posted 1 June 2020).
PACTR201811878799717 {published data only}
    1. PACTR201811878799717. Mobile phone SMS for adherence support for hypertension in South African adults in care for HIV infection [MObile Phone text messages to support Hypertension treatment ADherence in adults attending HIV treatment centres in the Western Cape Province of South Africa: a pilot study – The MOPHADHIV trial]. pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=4711 (first received 20 November 2018). [PACTR201811878799717]
Polgreen 2020 {published data only}
    1. Polgreen LA, Carter BL, Polgreen PM, Snyder PM, Sewell DK, Bayman EO, et al. A pharmacist intervention for monitoring and treating hypertension using bidirectional texting: PharmText BP. Contemporary Clinical Trials 2020;98:106169. [DOI: ] - PMC - PubMed
Ramallo‐Fariña 2020 {published data only}
    1. Ramallo-Fariña Y, García-Bello MA, García-Pérez L, Boronat M, Wägner AM, Rodríguez-Rodríguez L, et al. Effectiveness of internet-based multicomponent interventions for patients and health care professionals to improve clinical outcomes in type 2 diabetes evaluated through the indica study: multiarm cluster randomized controlled trial. JMIR mHealth and uHealth 2020;8(11):e18922. - PMC - PubMed
Schmidt 2018 {published data only}
    1. NCT03317951. Investigation of a novel integrated care concept (NICC) for patients suffering from chronic cardiovascular disease (CardioCare MV). clinicaltrials.gov/ct2/show/NCT03317951 (first received 23 October 2017).
    1. Schmidt C, Oener A, Mann M, Krockenberger K, Abbondanzieri M, Brandewiede B, et al. A novel integrated care concept (NICC) versus standard care in the treatment of chronic cardiovascular diseases: protocol for the randomized controlled trial CardioCare MV. Trials 2018;19(1):1-10. - PMC - PubMed
Steinert 2020 {published data only}
    1. Steinert A, Eicher C, Haesner M, Steinhagen-Thiessen E. Effects of a long-term smartphone-based self-monitoring intervention in patients with lipid metabolism disorders. Assistive Technology 2020;32(2):109-16. [DOI: 10.1080/10400435.2018.1493710] - DOI - PubMed
Tahkola 2020 {published data only}
    1. NCT02377960. Check and support - enhancing the treatment of hypertension in outpatient care, a multicenter study. clinicaltrials.gov/ct2/show/NCT02377960 (first received 4 March 2015).
    1. Tahkola A, Korhonen P, Kautiainen H, Niiranen T, Mäntyselkä P. Personalized text message and checklist support for initiation of antihypertensive medication: the cluster randomized, controlled check and support trial. Scandinavian Journal of Primary Health Care 2020;38(2):201-9. - PMC - PubMed
Tekkesin 2018 {published data only}
    1. NCT03397849. Lifestyle intervention using mobile technology in patients with high cardiovascular risk (LIGHT). clinicaltrials.gov/ct2/show/NCT03397849 (first received on 12 January 2018).
    1. Tekkesin A, Cinier G, Yildirimturk O, Soluk Ozdemir Y, Ersek S. Life style intervention using mobile technology in patients with high cardiovascular risk: a pragmatic randomized clinical Trial (LIGHT). European Journal of Preventive Cardiology 2018;25(Suppl 1):124.
Ueda 2020 {published data only}
    1. Ueda K, Kashiba A, Ooue C, Kimura A, Takeshita T, Arita M. Effects of a home blood pressure monitoring by mobile phone-based and health service (continuous antihypertensive treatment) in mild hypertension: the wakayama health promotion study. Atherosclerosis 2020;315:e81.
Williams 2020 {published data only}
    1. Williams SK, Johnson BA, Tobin JN, Luque AE, Sanders M, Carroll JK, et al. Protocol paper: stepped wedge cluster randomized trial translating the ABCS into optimizing cardiovascular care for people living with HIV. Progress in Cardiovascular Diseases 2020;63(2):125-33. [DOI: ] - PMC - PubMed

References to ongoing studies

AF‐EduApp 2018 {published data only}
    1. NCT03788044. Effect of targeted education for atrial fibrillation patients (application substudy) (AF-EDUAPP). clinicaltrials.gov/ct2/show/NCT03788044 (first received 27 December 2018).
BETTER‐BP 2020 {published data only}
    1. NCT04114669. Behavioral economics trial to enhance regulation of blood pressure (BETTER-BP). clinicaltrials.gov/ct2/show/NCT04114669 (first received 3 October 2019).
Buis 2019 {published data only}
    1. Buis LR, Dawood K, Kadri R, Dawood R, Richardson CR, Djuric Z, et al. Improving blood pressure among African Americans with hypertension using a mobile health approach (the MI-BP App): protocol for a randomized controlled trial. JMIR Research Protocols 2019;8(1):e12601. - PMC - PubMed
Byrne 2018 {published data only}
    1. Byrne JL, Dallosso HM, Rogers S, Gray LJ, Waheed G, Patel P, et al. The ready to reduce risk (3R) study for a group educational intervention with telephone and text messaging support to improve medication adherence for the primary prevention of cardiovascular disease: protocol for a randomized controlled trial.. JMIR Research Protocols 2018;7(11):e11289. - PMC - PubMed
Midlöv 2020 {published data only}
    1. Midlöv P, Nilsson PM, Bengtsson U, Hoffmann M, Wennersten A, Andersson U, et al. PERson-centredness in hypertension management using information technology (PERHIT): a protocol for a randomised controlled trial in primary health care. Blood Pressure 2020;29(3):149-56. - PubMed
    1. NCT03554382. Efficient self-management of chronic disease using health information technology - a study on hypertension (PERHIT) [PERson-centredness in hypertension management using information technology (PERHIT) study]. clinicaltrials.gov/ct2/show/NCT03554382 (first received June 13 2018).
NCT03973931 {published data only}
    1. NCT03973931. Personalized patient data and behavioral nudges to improve adherence to chronic cardiovascular medications. clinicaltrials.gov/ct2/show/NCT03973931 (first received 4 June 2019).
Redfern 2014 {published data only}
    1. Redfern J, Usherwood T, Harris MF, Rodgers A, Hayman N, Panaretto K, et al. A randomised controlled trial of a consumer-focused e-health strategy for cardiovascular risk management in primary care: the CONsumer Navigation of Electronic Cardiovascular Tools (CONNECT) study protocol. BMJ Open 2014;4(2):e004523. [DOI: ] - PMC - PubMed
Schroeder 2019 {published data only}
    1. Schroeder EB, Moore K, Manson SM, Baldwin MA, Goodrich GK, Malone AS, et al. An interactive voice response and text message intervention to improve blood pressure control among individuals with hypertension receiving care at an urban Indian health organization: protocol and baseline characteristics of a pragmatic randomized controlled trial. Journal of Medical Internet Research 2019;8(4):e11794. - PMC - PubMed
SMASH 2017 {published data only}
    1. NCT03454308. Patient centered health technology medication adherence program for African American hypertensives (SMASH). clinicaltrials.gov/ct2/show/NCT03454308 (first received 5 March 2018).
TEACH 2018 {published data only}
    1. NCT03724526. Text messaging and cardiovascular health in diabetes mellitus (TEACH). clinicaltrials.gov/ct2/show/NCT03724526 (first received 30 October 2018).
Venkateshmurthy 2018 {published data only}
    1. NCT03164317. To test the effectiveness of a trained nurse led, M-health enabled intervention to control blood pressure in India [A cluster randomised controlled trial of M-health enabled, nurse care coordinator led intervention to improve management of hypertension in India: m-Power Heart Project]. clinicaltrials.gov/ct2/show/NCT03164317 (first received 23 May 2017).
    1. Venkateshmurthy NS, Ajay VS, Mohan S, Jindal D, Anand S, Kondal D, et al. m-Power heart project - a nurse care coordinator led, mhealth enabled intervention to improve the management of hypertension in India: study protocol for a cluster randomized trial. Trials 2018;19(1):1-9. - PMC - PubMed
Xu 2017 {published data only}
    1. Xu L, Fang W, Zhu F, Zhang H, Liu K. A coordinated PCP-cardiologist telemedicine model (PCTM) in China's community hypertension care: study protocol for a randomized controlled trial. Trials 2017;18(1):236. [DOI: 10.1186/s13063-017-1970-z] - DOI - PMC - PubMed
Zhang 2020 {published data only}
    1. Zhang S, Wu S, Ren J, Chen X, Zhang X, Feng Y, et al. Strategy of blood pressure intervention in the elderly hypertensive patients (STEP): rational, design, and baseline characteristics for the main trial. Contemporary Clinical Trials 2020;89:105913. - PubMed

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Free 2016
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References to other published versions of this review

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