JMIR Publications

ABSTRACT

Background:

The use of mobile health management in the treatment of hypertension is progressively increasing. However, the advantages of multimodal digitally transformed mobile health management for patients diagnosed with mild-to-moderate hypertension are not yet established.

Objective:

To evaluate the therapeutic benefits of a novel WeChat-based multimodal digital transforming management (MDTM) model in mobile health blood pressure (BP) management.

Methods:

This randomized, controlled clinical trial included 175 individuals with new-onset mild-to-moderate hypertension who were admitted to our center between September and October 2022. The patients attended the 6-month follow-up visit and had complete data to analyze the clinical outcomes. The patients were randomly assigned to either the multimodal intervention group (n = 88) or the usual care group (n = 87). In the multimodal intervention group, we adopted digital transformation management to evaluate and systematize the presence of various risk factors, primary prevention programs for cardiovascular disease, and standardized management for hypertension. The primary composite outcome was home and office BP differences after 6 months. The major secondary outcomes were 6-month quality-of-life (QoL) scores, including the self-rating anxiety scale (SAS), self-rating depression scale (SDS), and Pittsburgh Sleep Quality Index (PSQI).

Results:

The mean home BP decreased from 151.74/94.22 to 126.19/82.28 mmHg in the multimodal intervention group and from 150.78/91.53 to 133.48/84.45 mmHg in the usual care group, with a mean difference in systolic BP and diastolic BP of -8.25 mmHg (95% confidence interval [CI] -11.71 to -4.78 mmHg) and -4.85 mmHg (95% CI -8.41 to -1.30 mmHg), respectively. The mean office BP decreased from 153.64/93.56 to 127.81/82.16 mmHg in the multimodal intervention group and from 151.48/91.31 to 134.92/85.09 mmHg in the usual care group, with a mean difference in systolic BP and diastolic BP of -9.27 mmHg (95% confidence interval [CI] -12.62 to -5.91 mmHg) and -5.18 mmHg (95% CI -8.47 to -1.89 mmHg), respectively. From baseline to 6 months, home BP control <140/90 mmHg was achieved in 64 patients (72.7%) in the multimodal intervention group and 46 patients (52.9%) in the usual care group (P = 0.007). Meanwhile, home BP control <130/80 mmHg was achieved in 32 patients (36.4%) in the multimodal intervention group and 16 patients (18.4%) in the usual care group (P = 0.008). The 6-month QoL scores (SAS, SDS, and PSQI) suggested that patients in the multimodal intervention group benefitted from the program.

Conclusions:

The novel WeChat-based multimodal intervention model improved the BP control rates and lowered the BP levels than the usual care approach. The MDTM model for hypertension represents an emerging medical practice that utilizes the individual’s various risk factor profiles for primary care and personalized therapy decision-making in patients with hypertension. Clinical Trial: The trial was registered in the Chinese Clinical Trial Registry (ChiCTR2200063550).