Digital Health Delivery Models for Hypertension Self-Care in Asia: A Systematic Review.

ABSTRACT: Hypertension remains a major contributor to cardiovascular morbidity in Asia, where effective long-term disease control depends substantially on patient self-care behaviors. Although digital health interventions are rapidly expanding, evidence regarding the effectiveness of different delivery models across specific self-care domains and clinical outcomes remains fragmented. PURPOSE: This study aimed to synthesize evidence on digital health delivery models for hypertension self-care in Asian populations and evaluate their effectiveness across self-care domains and clinical outcomes. METHODS: This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guideline. Eligibility criteria were defined using the Population, Intervention, Comparison, and Outcome (PICO) framework. PubMed, Scopus, and EBSCOhost were searched for randomized controlled trials published between 2015 and 2026 that evaluated digital health delivery models for hypertension self-care among Asian populations. Study quality was assessed using the Joanna Briggs Institute (JBI) critical appraisal tool. Data were synthesized descriptively through qualitative content analysis. RESULTS: Fourteen randomized controlled trials involving 2763 participants were included. Four major digital health delivery models were identified: web-based platforms, text messaging, mobile applications, and wearable-integrated systems. These interventions commonly incorporated education, monitoring, reminders, counseling, and feedback components. Overall, 11 of 14 studies (78.6%) reported significant improvements in hypertension self-care, particularly in self-care maintenance and monitoring behaviors. Text messaging-based interventions demonstrated relatively consistent effectiveness, especially among patients with cardiometabolic comorbidities. Several studies also reported reductions in systolic blood pressure, improved medication adherence, and favorable lifestyle modifications, although effects on self-care management were less consistent. CONCLUSION: Digital health delivery models show considerable potential to improve hypertension self-care in Asian populations, particularly for routine self-management behaviors. Future interventions should prioritize interactive, personalized, and feedback-driven approaches to strengthen complex self-care management and support scalable implementation.