Evaluating the impact of a structured digital health intervention on medication adherence in hypertensive patients
Аннотация
Hypertension affects over 70% of diagnosed patients in Uzbekistan with poor control, largely due to medication non-adherence amid urbanization and limited resources. This trial evaluated a structured digital health intervention (DHI) a multilingual Android app with reminders, education, and gamification on adherence in primary care settings. In this prospective RCT across three Tashkent clinics (March 2024–December 2025), 320 adults (40–75 years) with essential hypertension (BP ≥140/90 mmHg on monotherapy) were randomized 1:1 to DHI plus standard care or standard care alone. Primary outcome: 12-month adherence (MMAS-8 score). Secondaries: BP control, quality of life (EQ-5D-5L), utilization. Analysis: intention-to-treat mixed models (P<0.05). Baseline balanced (mean age 58 years, MMAS-8 ~5). DHI boosted adherence (7.2 vs. 5.4; mean diff 1.8, 95% CI 1.5–2.1, P<0.001; high adherence 89% vs. 58%). BP fell more (SBP -14.2 mmHg, 78.7% controlled vs. 41.3%, OR 5.6; both P<0.001). Utilization dropped (visits RR 0.62), EQ-5D +0.10 (P<0.001). Engagement high (85% reminders).This culturally tailored DHI markedly improved adherence, BP, and outcomes in Uzbekistan, supporting scalable digital integration for hypertension management.
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