title: Self-management of hypertension using technology enabled interventions in primary care settings.
abstract: BACKGROUND
  Self-management of hypertension by controlling Blood Pressure (BP) through technology-based interventions can effectively reduce the burden of high BP, which affects one out of every three adults in the United States.
  
  
  OBJECTIVE
  The primary aim of this study is to explore the role of technology enabled interventions to improve or enhance self-management among individuals with hypertension.
  
  
  METHODS
  We conducted a systematic review of the literature published between July 2008 and June 2013 on the MEDLINE database (via PubMed interface) during July 2013. The search words were "hypertension" and "primary care" in combination with each of the terms of "technology", "internet", "computer" and "cell phone". Our inclusion criteria consisted of: (a) Randomized Controlled Trials (RCTs) (b) conducted on human subjects; (c) technology-based interventions (d) to improve self-management (e) of hypertension and if the (f) final results of the study were published in the study. Our exclusion criteria included (a) management of other conditions and (b) literature reviews.
  
  
  RESULTS
  The initial search resulted in 108 results. After applying the inclusion and exclusion criteria, a total of 12 studies were analyzed. Various technologies implemented in the studies included internet-based telemonitoring and education, telephone-based telemonitoring and education, internet-based education, telemedicine via videoconferencing, telehealth kiosks and automated modem device. Some studies also involved a physician intervention, in addition to patient intervention. The outcomes of proportion of subjects with BP control and change in mean SBP and DBP were better for the group of subjects who received combined physician and patient interventions.
  
  
  CONCLUSIONS
  Interventions to improve BP control for self-management of hypertension should be aimed at both physicians as well as the patients. More interventions should utilize the JNC-7 guidelines and cost-effectiveness of the intervention should also be assessed.
authors.affiliation: Department of Health Services Research and Administration, College of Public Health, University of Nebraska Medical Center, Ohmaha, NE, USA.
authors.forename: Aastha
authors.initials: A
authors.lastname: Chandak
authors.affiliation: City University of New York School of Public Health, New York, NY, USA.
authors.forename: Ashish
authors.initials: A
authors.lastname: Joshi
mesh_terms: D006801:Humans; D006973:Hypertension / Q000628:therapy*; D010353:Patient Education as Topic / Q000379:methods; D011320:Primary Health Care / Q000379:methods*; D012648:Self Care / Q000379:methods*; D017216:Telemedicine / Q000379:methods*; D049269:Videoconferencing
keywords: Hypertension; education; interventions; management; technology