JMIR Publications

ABSTRACT

Background:

Limited research have investigated the influence of patient engagement on the long-term effects of mobile health (mHealth) interventions, particularly among older adults.

Objective:

This study aimed to examine the long-term impact of a social media-driven mHealth intervention on blood pressure control among elderly Chinese individuals with hypertension, through repeated measurements of patient engagement and outcomes at pre-set five time points.

Methods:

The study included elderly Chinese individuals with hypertension between 2017 and 2022. Participants received a hypertension self-management program via the WeChat social media app, which provided clinically based digital coaching. Blood pressure measurements were taken repeatedly using a home blood pressure monitor connected to the app at baseline, 3-, 6-, 9-, and 12-month. Patient engagement was evaluated based on the frequency of completed measurements at corresponding follow-ups. Latent growth curve models (LGCMs) served to assess impact of patient engagement on blood pressure among older individuals with hypertension across pre-set points.

Results:

A total of 1,723 patients completed the 12-month follow-up (average age: 70.7 years [SD 7.2], 55.8% female, baseline systolic blood pressure: 137.2 mm Hg). LGCMs revealed systolic blood pressure decreased significantly over one year, notably at 9 months (131 mmHg, β9=3.244, P<0.001), and continued up to 12 months (131.6 mmHg, β12=2.827, P<0.001). Additionally, a higher frequency of completed measurements was associated with better systolic blood pressure control at 3-, 6-, 9-, and 12-month (β3=–0.016, P=0.002; β6=–0.006, P=0.022; β9=–0.002, P=0.435; β12=–0.003, P=0.017). These results remained significant even after accounting for age, gender, and state of disease.

Conclusions:

This study, utilizing LGCMs and repeated measures data, reveals a significant positive impact of patient engagement on long-term blood pressure control in mHealth interventions targeting elderly individuals with hypertension. This research provides valuable insights into mHealth, advocating for integrating patient-centered engagement approaches into mHealth programs for chronic disease management in aging population.