Effectiveness of Mobile Health Interventions to Improve Medication Adherence Among Hypertensive Patients in Developing Countries: A Systematic Review

Nur Arifah Astri; Rifky Octavia Pradipta; Abu Bakar

doi:10.26714/mki.9.1.2026.60-70

Effectiveness of Mobile Health Interventions to Improve Medication Adherence Among Hypertensive Patients in Developing Countries: A Systematic Review

Nur Arifah Astri^(1*), Rifky Octavia Pradipta⁽²⁾, Abu Bakar⁽³⁾

(1) Department of Medical-Surgical, Emergency, Disaster, and Critical Care Nursing, Faculty of Nursing, Universitas Airlangga, Surabaya; Dementia and Aging Care Research Center, Surabaya, Indonesia
(2) Department of Medical-Surgical, Emergency, Disaster, and Critical Care Nursing, Faculty of Nursing, Universitas Airlangga
(3) Department of Medical-Surgical, Emergency, Disaster, and Critical Care Nursing, Faculty of Nursing, Universitas Airlangga
(*) Corresponding Author

Abstract

Hypertension often occurs in developing countries; limited availability of information about hypertension can lead to increased prevalence, low detection rates, and less than optimal prevention and control, especially in medication adherence. Articles were searched using the PRISMA framework with a search period of November 2025 to December 2025. Articles retrieved were from the last 5 years with a randomized trial (RCT) method, descriptive, and quasi-experimental studies with the keywords mobile health, telemedicine, telehealth, MHealth, medication adherence, and hypertension. Based on inclusion and exclusion criteria in the analysis of 7 articles from various countries that have been published and meet the criteria. Interventions provided were in the form of SMS to applications created by a team of experts. Mobile health (mHealth)-based interventions, both through SMS and simple applications, are effective in increasing medication adherence because they are easily accessible, cost-effective, and able to overcome the problem of forgetting and limited health literacy.

Keywords

mobile health; telehealth; MHealth; medication adherence; hypertension

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References

Kemenkes RI. Profil Kesehatan Indonesia 2023. 2023.

WHO. Hypertension. 2023.

Oktaviana Elisa, ispawati Heni Baik. Pengaruh Edukasi Terhadap Pengetahuan Pasien Hipertensi. J Penelit Perawat Prof 2023;5:263–8.

Levin JB, Moore DJ, Depp C, Montoya JL, Briggs F, Rahman M, et al. Using mHealth to improve adherence and reduce blood pressure in individuals with hypertension and bipolar disorder (iTAB-CV): study protocol for a 2-stage randomized clinical trial. Trials 2022;23:1–16. https://doi.org/10.1186/s13063-022-06449-9.

Piette JD, Marinec N, Janda K, Morgan E, Schantz K, Yujra ACA, et al. Structured caregiver feedback enhances engagement and impact of mobile health support: A randomized trial in a lower-middle-income country. Telemed e-Health 2016;22:261–8. https://doi.org/10.1089/tmj.2015.0099.

Spinean A, Mladin A, Carniciu S, Stănescu AMA, Serafinceanu C. Emerging Methods for Integrative Management of Chronic Diseases: Utilizing mHealth Apps for Lifestyle Interventions. Nutr 2025;17. https://doi.org/10.3390/nu17091506.

Faisal Tamimi, Siti Munawaroh. Teknologi Sebagai Kegiatan Manusia Dalam Era Modern Kehidupan Masyarakat. Saturnus J Teknol Dan Sist Inf 2024;2:66–74. https://doi.org/10.61132/saturnus.v2i3.157.

Bhandari B, Narasimhan P, Jayasuriya R, Vaidya A, Schutte AE. Effectiveness and Acceptability of a Mobile Phone Text Messaging Intervention to Improve Blood Pressure Control (TEXT4BP) among Patients with Hypertension in Nepal: A Feasibility Randomised Controlled Trial. Glob Heart 2022;17. https://doi.org/10.5334/GH.1103.

Abu-El-Noor NI, Aljeesh YI, Bottcher B, Abu-El-Noor MK. Impact of a mobile phone app on adherence to treatment regimens among hypertensive patients: A randomised clinical trial study. Eur J Cardiovasc Nurs 2021;20:428–35. https://doi.org/10.1177/1474515120938235.

Yuting Z, Xiaodong T, Qun W. Effectiveness of a mHealth intervention on hypertension control in a low-resource rural setting: A randomized clinical trial. Front Public Heal 2023;11. https://doi.org/10.3389/fpubh.2023.1049396.

Arshed M, Mahmud A, Minhat HS, Lim PY, Zakar R. Effectiveness of a Multifaceted Mobile Health Intervention (Multi-Aid-Package) in Medication Adherence and Treatment Outcomes Among Patients With Hypertension in a Low- to Middle-Income Country: Randomized Controlled Trial. JMIR MHealth UHealth 2024;12:e50248. https://doi.org/10.2196/50248.

Gong K, Yan YL, Li Y, Du J, Wang J, Han Y, et al. Mobile health applications for the management of primary hypertension: A multicenter, randomized, controlled trial. Med (United States) 2020;99:E19715. https://doi.org/10.1097/MD.0000000000019715.

Pereira A, Trombini R, Barbalho Y, Stival M, Lima L, Zandonadi R, et al. Strategies for Effective Communication in Hypertension Management: Validation of Messages from a Mobile Application to Assist Hypertensive Older Adults in Adherence to Treatment, Nutrition and Physical Activity. Nutr 2024;16. https://doi.org/10.3390/nu16244284.

Karami M, Ashtarian H, Rajati M, Hamzeh B, Rajati F. The effect of health literacy intervention on adherence to medication of uncontrolled hypertensive patients using the M-health. BMC Med Inform Decis Mak 2023;23:1–10. https://doi.org/10.1186/s12911-023-02393-z.

Moorhead P, Zavala A, Kim Y, Virdi NS. Efficacy and safety of a medication dose reminder feature in a digital health offering with the use of sensor-enabled medicines. J Am Pharm Assoc 2017;57:155-161.e1. https://doi.org/10.1016/j.japh.2016.12.067.

Breil B, Salewski C, Apolinário-Hagen J. Comparing the Acceptance of Mobile Hypertension Apps for Disease Management Among Patients Versus Clinical Use Among Physicians: Cross-sectional Survey. JMIR Cardio 2022;6. https://doi.org/10.2196/31617.

Yeung DL, Alvarez KS, Quinones ME, Clark CA, Oliver GH, Alvarez CA, et al. Low–health literacy flashcards & mobile video reinforcement to improve medication adherence in patients on oral diabetes, heart failure, and hypertension medications. J Am Pharm Assoc 2017;57:30–7. https://doi.org/10.1016/j.japh.2016.08.012.

Peters RM, Shivakumar N, Xu R, Javaherian K, Sink E, Patel K, et al. Assessing the utility of a novel SMS- And phone-based system for blood pressure control in hypertensive patients: feasibility study. JMIR Cardio 2017;1:1–10. https://doi.org/10.2196/cardio.7915.

Zha P, Qureshi R, Porter S, Chao YY, Pacquiao D, Chase S, et al. Utilizing a Mobile Health Intervention to Manage Hypertension in an Underserved Community. West J Nurs Res 2020;42:201–9. https://doi.org/10.1177/0193945919847937.

Amadu AB, Konlan KD, Amadu JB, Dzansi G. Treatment Adherence and Quality of Life of Adults Living With Hypertension in Rural Ghana. Nurs Open 2025;12. https://doi.org/10.1002/nop2.70198.

Pinto C, Chaves C, Duarte J, Raposo A, Zandonadi RP, Monteiro S, et al. Exploración de los factores relacionados con el estilo de vida y el cumplimiento del tratamiento entre los adultos mayores con hipertensión que acuden a una unidad móvil de salud (MHU) en una zona rural del centro de Portugal. Nutrients 2024;16:1112.