JMIR Publications

ABSTRACT

Background:

Hypertension affects over 15% of the world's population and is a significant global public health and socioeconomic challenge. Mobile health (mHealth) services have been increasingly introduced to support hypertensive patients to improve self-management behaviours, i.e. adherence to pharmacotherapy and lifestyle modifications.

Objective:

This study aims to explore patient perceptions of the most valuable characteristics of such services to support patients' self-management of hypertension.

Methods:

A semi-structured, in-depth interview study was conducted with 22 outpatients of the General Hospital of Ningxia Medical University from March to May 2019. The hospital had introduced a mHealth service to support community-dwelling, outpatients with self-management of hypertension since 2015. The data were analysed using the constant comparison method of grounded theory. Each sentence of the transcripts was split into atomic units with a unique meaning and coded. The codes were then reassembled into higher-level content categories.

Results:

The patient-perceived mechanism of the mHealth service for supporting their self-management of hypertension can be summarised as six 'A's: access, assessment, assistance, awareness, ability, and activation. With the portability of mobile phones and digitisation of information, the mHealth service provided the outpatients with easy access to assess their vital signs and self-management behaviours. The assessment results gave the patients real-time awareness of their health conditions and self-management performance, activating their self-management behaviours. The mHealth service also gave the outpatients access to assistance which included health education and self-management reminders. Both types of assistance could also be activated by abnormal assessment results, i.e. uncontrolled or deteriorating BP value, discomfort symptoms, or not using the system for a long period. With its scalable usage to handle any possible information and services, the mHealth service provided the outpatients with educational materials to learn at their own pace. This led to an improvement in self-management awareness and ability, again activating their self-management behaviours.

Conclusions:

The mHealth service extended the traditional hypertension care model beyond the hospital and clinician's office. It provided the outpatients with easy access to otherwise inaccessible hypertension management services. This led to process improvement for outpatients to access health assessment and healthcare assistance and improved their awareness and self-management ability, which activated their hypertension self-management behaviours.