Effectiveness Of Mobile Health In Blood Pressure Control Of Patients With Hypertension

[Objectives] The aim of using meta-analysis is to study the effectiveness of mobile health in blood pressure control of patients with hypertension,and provide evidence for the application of mobile health in hypertension.[Methods] Searching the database of PubMed,The Cochrane Library,Web of Science?Embase,CNKI,Wanfang,CBM.and to find the relevant literature on the randomized controlled trials of mobile health care for patients with hypertension,and the search time was from the establishment of the database to December 2018.The two researchers screened the searched literature separately according to the literature inclusion and exclusion criteria.For the literatures included in the study after the screening was completed,the relevant research feature data was extracted,and the quality of the included literature was evaluated,and meta-analysis was performed using Stata11.0 software.[Results] A total of 15 randomized controlled trials were included,including 10 Chinese articles and 5 English articles.A total of 2917 hypertensive patients were included.The blood pressure values of 15 literatures after hypertension intervention were combined and analyzed.Heterogeneity test revealed heterogeneity.Therefore,data were combined using random effects model.The results showed that mobile health can significantly reduce SBP(WMD=-8.375,95%CI=-12.524~-4.227,P<0.001)and DBP(WMD=-4.717,95%CI=-7.28~-2.153,P<0.001)compared with conventional care.Because of the heterogeneity,sensitivity analysis and subgroup analysis were conducted to discuss the source of heterogeneity.Sensitivity analysis showed that the stability and reliability of the results of the meta-analysis were better.Subgroup analysis showed:(1)Intervention subgroup: In the APP subgroup,the intervention group compared with the control group can significantly reduce SBP(WMD=-8.531,95%CI=-13.661~-3.402,P<0.001)and DBP(WMD=-5.198,95% CI=-7.729~-2.667,P<0.001).In the SMS subgroup,there was no significant difference in SBP between the intervention group and the control group(WMD=-7.640,95%CI=-17.166~1.886,P=0.116).There was no significant difference in DBP(WMD=-3.215,95%CI=-9.098~2.668,P=0.284).(2)Follow-up time Subgroup: no follow-up time of 6 months in the subgroup,the intervention group compared with the control group,can significantly reduce SBP(WMD=-6.420,95%CI=-9.532~-3.308,P< 0.001)and DBP(WMD=-3.021,95%CI=-4.500~-1.542,P<0.001).In the subgroup of more than 6 months,the intervention group compared with the control group significantly reduced SBP(WMD=-14.034,95%CI=-22.026~6.041,P<0.001)and DBP(WMD=-8.441,95%CI=-12.491~-4.392,P<0.001).Finally,a publication bias test suggests that there is a publication bias in the meta-analysis.[Conclusions] Compared with conventional care,mobile health treatment shows certain advantages in lowering blood pressure.Mobile health treatment is expected to improve the clinical effect of hypertension management,and it is worthy of popularization and application.In addition,hypertensive patients improved their blood pressure compared with the control group after long-term and short-term mobile health intervention,and long-term mobile health intervention was better than short-term.The use of APP intervention is better than the use of SMS alone.APP intervention is generally associated with other devices or functions,and most mobile interventions currently have multiple characteristics.The use of this feature is more conducive to intervention effect.