Abstract 15365: The Effect of Mobile Phone Messaging in the Reduction of Ambulatory Blood Pressure in Adults: A Systematic Review

Abstract

Introduction: Ample evidence supports a lower risk for cardiovascular disease (CVD) with controlled blood pressure (BP), yet hypertension (HTN) remains a leading cause of CVD. Mobile health such as text messaging is commonly included in BP management programs; however, the association of texting with BP interventions is less well known. We sought to examine the effectiveness of mobile messaging on BP in adults in the ambulatory setting. Methods: In this systematic review, we searched 4 databases from date of inception through February 2023 using search terms (texting, messaging, mobile phone, BP, HTN). After removing duplicate citations, two reviewers independently reviewed the references for eligibility (randomized control trial [RCT], participants > 18 years of age, participants either with elevated BP, and/or a diagnosis of HTN). Results: A total of 1,786 RCTs were identified of which 48 met eligibility criteria, for a combined total of 19,720 participants from 21 countries, including 13 US studies. Twenty-seven studies reported significant reductions in BP (systolic, diastolic or both). All three RCTs using texting and pharmacist counseling (n=3) demonstrated significant changes in BP, while 13 of 16 RCTs with texting and provider involvement observed significant improvement in BP. For the studies reporting between group changes in systolic BP from baseline, 7 studies noted significant improvements in BP (Figure 1). Conclusions: Despite heterogeneity in study components, we found text messaging when used with other intervention components was associated with BP reductions among adults with HTN. Larger studies using novel designs such as SMART (sequential multiple assignment randomized trials) are warranted to understand efficacy of texting with other intervention components.