Systematic Review/Meta-analysisReducing Blood Pressure With Internet-Based Interventions: A Meta-analysis
Section snippets
Methods
This meta-analysis was based on guidelines from the Cochrane Handbook for Systematic Reviews of Interventions.13 Reporting of results followed the Preferred Items of Systematic Reviews and Meta-Analyses guidelines.14
Article selection
A total of 908 studies were identified within our database search. After reviewing the abstract and removing duplicate publications, 54 full-text articles were reviewed. Out of these articles, 13 met the inclusion criteria (Fig. 1).
Study characteristics
Six of the studies were conducted in the United States, 3 in South Korea, 2 in Canada, 1 in Australia, and 1 in Germany. There were a total of 11 randomized control trials and 2 studies that matched controls by age, sex, body weight, and blood pressure. See
Discussion
The primary aim of the present meta-analysis was to evaluate the effectiveness of Internet-based interventions in reducing blood pressure in individuals with prehypertension or hypertension. We found that Internet-based interventions significantly reduced SBP by 3.8 mm Hg and DBP by 2.1 mm Hg. It is noteworthy that this change in SBP was comparable to the magnitude of blood pressure reduction reported in previous meta-analyses of face-to-face lifestyle counselling.3, 4 A reduction in SBP of 3
Conclusion
There is preliminary evidence supporting the efficacy of e-counselling as a complementary intervention for managing blood pressure. We found that Internet-based interventions may be more efficacious when a program lasts 6 months or longer, is delivered proactively, and provides at least 5 behaviour change techniques. In order to build an evidence-based guideline for preventive e-counselling, there is an immediate need to design trials that provide a direct comparison of specific intervention
Funding Sources
S. Liu was supported by the Ontario Student Opportunity Trust Fund.
Disclosures
The authors have no potential conflicts of interest.
References (40)
- et al.
Global burden of blood-pressure-related disease, 2001
Lancet
(2008) - et al.
Canadian Hypertension Education Program. The 2009 canadian hypertension education program recommendations for the management of hypertension: Part 2—therapy
Can J Cardiol
(2009) - et al.
Website-delivered physical activity interventions: a review of the literature
Am J Prev Med
(2007) - et al.
Internet-based behavioral change and psychosocial care for patients with cardiovascular disease: a review of cardiac disease-specific applications
Heart Lung
(2006) - et al.
Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement
Int J Surg
(2010) - et al.
Imputing missing standard deviations in meta-analyses can provide accurate results
J Clin Epidemiol
(2006) - et al.
Therapeutic benefit of Internet-based lifestyle counselling for hypertension
Can J Cardiol
(2012) - et al.
Cellular phone and Internet-based individual intervention on blood pressure and obesity in obese patients with hypertension
Int J Med Inform
(2009) - et al.
Efficacy of a weight-loss website based on positive deviance: a randomized trial
Am J Prev Med
(2011) - et al.
Treating obesity with a novel hand-held device, computer software program, and Internet technology in primary care: the SMART motivational trial
Patient Educ Couns
(2010)
An Internet-delivered exercise intervention for workplace health promotion in overweight sedentary employees: a randomized trial
Prev Med
Evaluation of mobile phone and Internet intervention on waist circumference and blood pressure in post-menopausal women with abdominal obesity
Int J Med Inform
Effect of aerobic exercise on blood pressure: a meta-analysis of randomized, controlled trials
Ann Intern Med
Lifestyle interventions to reduce raised blood pressure: a systematic review of randomized controlled trials
J Hypertens
Why are health care interventions delivered over the Internet? A systematic review of the published literature
J Med Internet Res
Telehealth interventions for the secondary prevention of coronary heart disease: a systematic review
Eur J Cardiovasc Prev Rehabil
Directive and nondirective e-coach support for weight loss in overweight adults
Ann Behav Med
Using the Internet to promote health behavior change: a systematic review and meta-analysis of the impact of theoretical basis, use of behavior change techniques, and mode of delivery on efficacy
J Med Internet Res
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2023, Biomedical and Environmental SciencesComparative effect of eHealth interventions on hypertension management-related outcomes: A network meta-analysis
2021, International Journal of Nursing StudiesCitation Excerpt :However, eHealth is often designed to support the achievement of health goals, such as assisting in the self-management of chronic diseases, including hypertension (Free et al., 2013). Although several previous systematic reviews (Andre et al., 2019; Xiong et al., 2018; Zullig et al., 2013) and meta-analyses (Choi et al., 2020; Lu et al., 2019; Li et al., 2020, Liu et al., 2013; Ma et al., 2019; Omboni and Guarda, 2011; Omboni et al., 2013; Verberk et al., 2011) have been published on the effect of eHealth interventions mainly on controlling and reducing systolic and diastolic blood pressures, none of them have quantitatively compared the effect of different types of eHealth interventions (phone calls, blood pressure telemonitoring, emails, web-site, smartphone-app, short message service [SMS] and more than two eHealth interventions) on the self-management of hypertension. Therefore, the aim of this network meta-analysis was to compare the effect of different types of eHealth interventions on reducing systolic and diastolic blood pressure, increasing adherence to medication treatment, improving physical activity compliance, controlling blood pressure, and improving quality of life (QoL).
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