title: Digital Interventions to Promote Self-Management in Adults With Hypertension: Protocol for Systematic Review and Meta-Analysis.
abstract: BACKGROUND
  Digital interventions, defined as any intervention accessed and taking input from patients in the form of a computer/Web-based program or mobile phoned-based app, can potentially help empower patients to self-manage long-term conditions such as hypertension. Importantly, digital interventions have the potential to provide patients with personalized information and support for active involvement in treatment as well as cost saving.
  
  
  OBJECTIVE
  The purpose of this systematic review is to synthesize the evidence for using digital interventions to support patient self-management of hypertension, and determine their impact on control and reduction of blood pressure, other clinical outcomes, quality of life, medication adherence, health service utilization, and economic benefits.
  
  
  METHODS
  A systematic search of bibliographic databases including Medline, Embase, CINAHL, and PsycINFO will be undertaken. Abstracts and citations will be independently screened by 2 researchers against predetermined inclusion criteria. Any disagreements will be resolved by discussion and further consideration of the inclusion criteria. Only randomized controlled trials which have been published in peer peer-reviewed journals with a diagnosis of hypertension will be considered. Inclusion criteria will be (1) adults (age ≥ 18 years) with hypertension (as defined by the primary authors); (2) an interactive digital intervention compared with usual care; and (3) outcomes of objectively measured change in blood pressure. Data extraction from identified articles will be undertaken by 2 independent reviewers using a uniform template. The main outcomes are systolic blood pressure (SBP) and diastolic blood pressure (DBP), and quality of life indicators. Secondary outcomes include cost- effectiveness, medication adherence, emotional well-being, and physical activity. Risk of bias of included studies will be assessed using the Cochrane tool.
  
  
  RESULTS
  Our research is currently ongoing. Data will be summarized narratively, and if possible, meta-analyses will be performed to assess the impact of the interventions on outcomes.
  
  
  CONCLUSIONS
  By summarizing and synthesizing available data, this review will help inform policy on the use of digital interventions for self-management of hypertension and will clarify areas for further research.
  
  
  BACKGROUND
  Prospero 2014: CRD42014010268; http://www.crd.york.ac.uk/PROSPERO/display_record.asp? ID=CRD42014010268 (Archived by WebCite at http://www.webcitation.org/6c5alQQJL).
authors.affiliation: Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom. gary.mclean@glasgow.ac.uk.
authors.forename: Gary
authors.identifier: http://orcid.org/0000-0003-4686-0949
authors.initials: G
authors.lastname: McLean
authors.forename: Elizabeth
authors.identifier: http://orcid.org/0000-0002-8932-3695
authors.initials: E
authors.lastname: Murray
authors.forename: Rebecca
authors.identifier: http://orcid.org/0000-0001-5403-1708
authors.initials: R
authors.lastname: Band
authors.forename: Kathryn
authors.identifier: http://orcid.org/0000-0002-1167-8146
authors.initials: K
authors.lastname: Saunderson
authors.forename: Peter
authors.identifier: http://orcid.org/0000-0002-5828-3934
authors.initials: P
authors.lastname: Hanlon
authors.forename: Paul
authors.identifier: http://orcid.org/0000-0003-3664-1873
authors.initials: P
authors.lastname: Little
authors.forename: Richard J
authors.identifier: http://orcid.org/0000-0003-3638-028X
authors.initials: RJ
authors.lastname: McManus
authors.forename: Lucy
authors.identifier: http://orcid.org/0000-0002-3853-883X
authors.initials: L
authors.lastname: Yardley
authors.forename: Frances S
authors.identifier: http://orcid.org/0000-0001-9780-1135
authors.initials: FS
authors.lastname: Mair
keywords: digital intervention; hypertension; self-management