A chatbot-based hypertension management program and its effects on knowledge, health behaviors, medication adherence, blood pressure, and biomarkers among community-dwelling older adults with hypertension: Program development, feasibility and preliminary effects
Keywords:
hypertension management, chatbot, community-dwelling older adultAbstract
Hypertension is a common non-communicable disease among community-dwelling older adults, requiring continuous blood pressure control. The number of older adults attending the outpatient department at Srinagarind Hospital has been increasing annually. Older patients accounted for 38-40% of all patients during 2023 and 2024. Although this group has access to treatment, their ability to control blood pressure remains suboptimal. This is due to a one-way communication model in education, counseling, discontinuous follow-up, and high nursing workload, which constrain long-term self-management support.
This study aimed to develop, evaluate the feasibility, and examine the preliminary effects of a chatbot-based hypertension management program. A quasi-experimental onegroup pretest–posttest design was conducted in 15 older adults aged 60 years or older with adequate cognitive function and digital literacy skills, smartphone access, and LINE application proficiency. Participants were recruited from the outpatient department of Srinagarind Hospital. The 12-week program included health education, lifestyle modification support, continuous follow-up, and consultation through a chatbot embedded in the Line application, incorporating automated reminders and positive reinforcement for hypertension management. Data were collected at baseline and after the 12-week intervention.
The chatbot-based hypertension management program was developed with excellent content validity (CVI = 0.98; IOC = 0.97). In-depth interviews indicated that the chatbot helped users recognize personal risk factors, supported health behavior modification, and was easy to use. However, some participants suggested that the content should be more concise. All 15 participants completed the program, yielding a 100% retention rate, with a total of 1,413 interactions via the chatbot, of which 87.26% were automatically processed correctly. The most frequently used functions were educational videos (40.11%), the electronic manual (35.16%) and text-based consultation (13.74%) respectively.
In the preliminary outcome assessment, participants had a mean age of 69.07 ± 5.38 years. The statistically significant improvements were observed in knowledge (15.60 ± 1.05 to 16.53 ± 1.18; p = 0.004), health behaviors (23.07 ± 3.86 to 25.33 ± 4.09; p=0.007), medication adherence (20.70 ± 2.86 to 21.61 ± 2.61; p = 0.008), and systolic blood pressure (133.67±11.89 to 127.07 ± 11.22 mmHg; p = 0.014). However, biomarker outcomes were not analyzed during this feasibility phase due to time constraints.
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