Effectiveness of a mobile health app on initiated antihypertensive medications in patients with untreated hypertension

Background Few effective tools have been identified that facilitate the initiation of antihypertensive medications in patients with untreated hypertension. To determine whether a mobile health (mHealth) application facilitates the initiation of antihypertensive medications in patients with untreated hypertension. Methods We analyzed a large, longitudinal, integrated database mainly comprising middle-aged, working people and their families. The database contained health checkup data, health insurance claims data, and mHealth app data. The mHealth app, kencom, is used to manage daily life logs (i.e. weight, number of steps) and to provide health information tailored to customers. Patients with untreated hypertension were defined using the baseline health checkup data. A multivariable logistic regression analysis was performed to examine the association between use of the mHealth app and the initiation of antihypertensive medications. Results Among 50 803 eligible patients (mean age, 49 years; 78 % male) with a median follow-up period of 3.0 years. The rate of initiation of antihypertensive medication was 23.4 % vs. 18.5 % (p < 0.0001), which was significantly higher in the mHealth application group (n = 14 879) than in the non-user group (n = 35 924). Multivariable analysis revealed that usage of the mHealth app was associated with initiated antihypertensive medications (odds ratio 1.43, 95 % confidence interval 1.36–1.50). Conclusion In patients with untreated hypertension, the use of the mHealth app, which was not dedicated to hypertension treatment, was associated with the initiation of antihypertensive medications. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement There was no funding. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: This study was approved by the institutional review boards of all participating institutions. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes The datasets generated and analyzed during the current study are not publicly available due to limitations of ethical approval involving patient data and anonymity but are available from the corresponding author upon reasonable request. * mHealth : mobile health AMEs : average marginal effects