JMIR Publications

ABSTRACT

Background:

Hypertension seriously affects the lives and health of people worldwide. Hypertension management applications (HMAs) can help patients control blood pressure, and their effectiveness has been confirmed in clinical trials. However, the use of HMAs remains unsatisfactory. Currently, there is a lack of real-world research based on big data and exploratory mining comparing Chinese and American HMAs.

Objective:

To systematically collect HMAs and their user reviews in China and the United States; use data mining to compare HMA user experience, satisfaction level, influencing factors, and asymmetry for Chinese and American users; evaluate the differences between satisfaction and its influencing factors; and explore the asymmetry of the factors.

Methods:

HMAs and user reviews were obtained from 10 major Chinese and American App stores worldwide. The Latent Dirichlet Allocation (LDA) topic model identified user review topics. The Tobit model was used to explore the effects and differences of each topic on user satisfaction. The Wald test was used to analyze effect differences.

Results:

We included 261 HMAs with user reviews and 116,686 user reviews. For the number and overall satisfaction of HMAs, Chinese HMAs (91 vs. 220) and reviews (16,561 vs. 100,125) were fewer than their American counterparts. The overall HMA user satisfaction rate was 75.2%, with a higher satisfaction with Chinese HMAs (83.7% vs. 73.8%). For the user focus to the HMAs, reliability (n=2,165, 13.1%) and measurement accuracy (n=2,091, 12.6%) are the concerns of Chinese users, while American users pay more attention to blood pressure tracking (n=17,285, 17.3%) and data synchronization (n=12,837, 12.8%). For factors influencing user satisfaction, seven factors significantly affected the positive rating deviation (PD) of Chinese HMA user satisfaction, and eight factors for the negative rating deviation (ND). Among them, the factors with the greatest effects on PD and ND are blood pressure tracking (β=0.354; P<0.001) and cost (β=3.703; P<0.001), respectively. All 12 factors significantly affected the PD and ND of American HMA user satisfaction. Among them, blood pressure tracking (β=0.312; P<0.001) and data synchronization (β=2.662; P<0.001) have the greatest effects on PD and ND, respectively. The effects of Chinese and American HMA user satisfaction factors significantly differed in the positive deviation and negative.

Conclusions:

User satisfaction factors in different countries were asymmetric and considerably different. For Chinese HMA users, ease of use and interface design are motivational factors, while cost, measurement accuracy, and compatibility mainly affected user dissatisfaction. For American HMA users, ease of use, blood pressure tracking, blood pressure management effect, interface design, measurement accuracy, and cost are motivational factors, while data sharing, synchronization, software reliability, compatibility, heart rate detection, and advertisement distribution were basically required by users. Personalized experience plans based on user groups should be developed in different countries.