Accepted for/Published in: JMIR Formative Research
Date Submitted: Jan 20, 2026
Date Accepted: Oct 19, 2026
Outcomes Associated with a WhatsApp-Based Telehealth Education Program and Remote Follow-Up on Blood Pressure, Medication Adherence, and Self-Care: A Formative Quasi-Experimental Pilot Study in Jordan
ABSTRACT
Background:
Hypertension is a common chronic condition associated with substantial morbidity globally. In Jordan, many patients struggle with sustained medication adherence and self-management, highlighting a need for accessible care strategies. Low-cost platforms like WhatsApp may support telehealth education and remote follow-up, though formative pilot data are needed to assess feasibility in this context.
Objective:
To evaluate the outcomes associated with a formative WhatsApp-based telehealth education program and structured remote follow-up on blood pressure, medication adherence, and self-care behaviors among adults with primary hypertension in Jordan.
Methods:
A quasi-experimental, single-group pretest-posttest pilot study was conducted. Forty adults (aged 28–60 years) with primary hypertension were recruited from a university hospital. The 8-week hybrid mHealth intervention involved training participants in home blood pressure monitoring, delivering daily educational multimedia messages via WhatsApp (covering diet, exercise, and medication), and conducting biweekly structured telephone consultations with a nurse and dietitian. Validated tools (Hill-Bone Scale, BP Self-Care Scale, BP Knowledge Scale) and electronic sphygmomanometers were used at baseline and post-intervention. Data were analyzed using Wilcoxon signed-rank tests.
Results:
All 40 participants completed the 8-week pilot. Following the intervention, participants demonstrated improvements in medication adherence and self-care behavior scores. Both systolic and diastolic blood pressure levels were lower post-intervention compared to baseline. Additionally, hypertension-related knowledge scores increased.
Conclusions:
This formative pilot study suggests that a WhatsApp-based educational intervention with remote telephone follow-up is a feasible approach associated with improved blood pressure management and self-care among select patients in Jordan. Given the small sample and single-group design, these preliminary findings cannot establish causality but provide foundational evidence to justify future, fully powered randomized controlled trials. Clinical Trial: Not applicable (nonrandomized, quasi-experimental pre-post study).
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