SELF-MANAGEMENT OF HYPERTENSION: A SYSTEMATIC REVIEW OF MOBILE APPLICATIONS

D. Manlapaz¹, C.R. Versales¹, L.P. Tangcuangco¹, X.E. Beltran¹, S.A. Chen¹, E.D. Florin¹, G.S. Garcia¹, K.K.K. Li¹, K.R. Robles¹, D.J. Sia Tan¹, G. Valentos¹

¹University of Santo Tomas, Department of Physical Therapy, Manila, Philippines

Background: The role of a physiotherapist is crucial in providing patient education and home exercise programs. Mobile Health (mHealth) applications are gradually gaining a significant role in managing patients with hypertension, yet there is limited research regarding their application.

Purpose: This study aimed to describe applications geared toward self-management of hypertension and evaluate their quality, functionality, content validity, and usefulness.

Methods: A systematic review of mobile applications was conducted from the Google Play and Apple App Store following the protocol registered in Open Science Framework Registries (https://osf.io/ptyeq). Inclusion criteria included applications for self-management of hypertension that were created within five years, smartphone-based, and run on Android OS or iOS. Selected mobile applications were evaluated by the Mobile Application Rating Scale (MARS). MARS is a 23-item questionnaire, each with a five-point response scale (1: Inadequate, 2: Poor, 3: Acceptable, 4: Good, 5: Excellent). This assesses the application's quality on four domains, further categorized into subtypes: Engagement, Functionality, Aesthetics, and Information. Each domain's mean scores were calculated instead of the total score due to the possibility of a 'not applicable' response during the rating.

Results: A total of 1607 applications were filtered, leaving 266 applications. Twelve were compliant with the criteria. However, six of these applications have in-app purchases, thereby failing to comply with the inclusion criteria. These applications were included because the researchers considered that some applications could function effectively even without availing of in-app purchases. These applications were downloaded for a complete data extraction which filtered the applications further. The FITZY+ obtained the highest MARS average (4.06). The functionality domain scored highest among the applications. All applications adhered to the treatment of hypertension and prevention.

Conclusions: Mobile health applications are promising tools capable of minimizing the occurrence and degree of hypertension. However, the applications for self-management of hypertension have substandard quality due to inadequate information brought about by limited research and regulation. Although these applications satisfy some clinical guidelines and are seemingly able to help in the self-management of hypertension through its functionalities such as monitoring and encouragement of lifestyle modifications, physiotherapists should advise their patients not to solely rely on them as they are not the most optimal form of medical care.

Implications: Developers of mHealth applications should invest more in evidence-based content and use this review to enhance service, usefulness, and consumer experience further. Additionally, developers should also collaborate with clinicians, researchers, organizations, and targeted users such as people with hypertension to establish a standardized method for evaluating applications and ensuring that they are safe and beneficial to the patients.

Funding acknowledgements: Not applicable

Keywords:
Hypertension
Mobile application
mHealth

Topics:
Cardiorespiratory
Non-communicable diseases (NCDs) & risk factors

Did this work require ethics approval? No

Reason: The study did not involve humans as participants. This is a review (secondary study).