JMIR Publications

ABSTRACT

Background:

Hypertensions is a widespread chronic disease whose effective treatment requires patients to self-manage. The global growth in health-related apps provide an effective way of supporting hypertension self-management. However, the increasing range and variety of hypertension apps available on the market creates the need for patients and healthcare professionals to be informed about the effectiveness of these apps and the levels of privacy and security that they provide.

Objective:

To describe and assess all available apps supporting hypertension self-management in the most popular app stores, and investigate their functionalities

Methods:

In January 2018, the UK Apple and Google play stores were scanned for all free and paid apps supporting hypertension self-management. Apps were included if they were in English, had functionality supporting hypertension self-management, and targeted adult users with hypertension. The included apps were downloaded and their functionalities were investigated. Behavior change techniques (BCTs) linking with the theoretical domain framework (TDF) underpinning potentially effective apps were independently coded by 2 reviewers. The data privacy and security of the apps were also independently assessed.

Results:

186 hypertension apps that met the inclusion criteria were included in this review. The majority of these apps had only one functionality (n= 108), while the remainder offered different combinations of functionalities. A small number of apps had comprehensive functionalities (n=30) that are likely to be more effective in supporting hypertension self-management. Most apps lacked a clear theoretical basis. 24 BCTs identified in these 30 apps were mapped to 10 TDF mechanisms of actions. On average, 9 BCTs were mapped to 6 TDF mechanisms of actions that may support hypertension self-management behaviors. There was a concerning absence of evidence relating to the effectiveness and usability of all 186 apps, and involvement of healthcare professionals in the app development process was minimal. Most apps did not meet current standards regarding data security and privacy

Conclusions:

Despite the widespread accessibility and availability of smartphone apps with a range of combinations of functionalities that can support the self-management of hypertension, only a small number of these apps are likely to be effective. Many apps lack security measures, a clear theoretical basis, and do not provide any evidence concerning their effectiveness and usability. This raises a serious issue as health professionals and those with hypertension have insufficient information on which to base decisions regarding which apps are safe and effective