Digital home-based monitoring for patients with hypertension and type 2 diabetes in Ghana
Abstract
Background: Long-term conditions such as high blood pressure and type 2 diabetes are growing concerns in Sub-Saharan Africa, where routine clinic-based monitoring can be difficult. Digital health tools may help support home-based care, yet evidence from the region remains limited. This study examines whether a smartphone-based remote monitoring system can support long-term management of high blood pressure and fasting blood glucose among adults receiving care in Accra, Ghana.
Methods: We followed 481 adults aged 18-85 years with high blood pressure and/or type 2 diabetes who recorded home measurements through a smartphone remote-monitoring platform while attending three outpatient clinics. High blood pressure control was defined by age-specific thresholds, and fasting blood glucose control was defined as values below 7.0 millimoles per litre. We analysed changes in home measurements over time and identified factors associated with achieving control at twelve months. We also examined predictors of early blood pressure control using time-to-event analysis.
Results: Both systolic and diastolic blood pressure decrease significantly within six months and remain lower at twelve months and beyond. Individuals who begin with uncontrolled values show the largest improvements. Although overall fasting blood glucose does not change significantly, those uncontrolled at baseline show a meaningful decline over time. After one year, the proportion of individuals with controlled blood pressure increases from 39 percent to 62 percent, and most participants who start uncontrolled achieve at least one controlled reading during follow-up.
Conclusions: Smartphone-supported home monitoring is feasible in an urban African setting and is associated with meaningful long-term improvement in blood pressure. While reductions in fasting blood glucose are less consistent, the findings indicate that digital health tools can support chronic disease care and highlight opportunities to strengthen strategies for improving blood glucose control over time.
Related
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BibTeX
@article{andel2026digital,
title = {{Digital home-based monitoring for patients with hypertension and type 2 diabetes in Ghana}},
author = {Judith M. van Andel and Pearl Aovare and Gloria P. Gómez-Pérez and Francis Addai and Emmanuel Amoah and Alfred Toppar and Victor Abugri and Alex Attachey and Gifty Sunkwa-Mills and Tobias F. Rinke de Wit and Charles Agyemang},
journal = {Communications Medicine},
year = {2026},
month = oct,
doi = {10.1038/s43856-026-01774-5},
url = {https://www.nature.com/articles/s43856-026-01774-5},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Digital home-based monitoring for patients with hypertension and type 2 diabetes in Ghana
AU - Judith M. van Andel
AU - Pearl Aovare
AU - Gloria P. Gómez-Pérez
AU - Francis Addai
AU - Emmanuel Amoah
AU - Alfred Toppar
AU - Victor Abugri
AU - Alex Attachey
AU - Gifty Sunkwa-Mills
AU - Tobias F. Rinke de Wit
AU - Charles Agyemang
PY - 2026
DA - 2026/10/28
JO - Communications Medicine
DO - 10.1038/s43856-026-01774-5
UR - https://www.nature.com/articles/s43856-026-01774-5
AB - Background: Long-term conditions such as high blood pressure and type 2 diabetes are growing concerns in Sub-Saharan Africa, where routine clinic-based monitoring can be difficult. Digital health tools may help support home-based care, yet evidence from the region remains limited. This study examines whether a smartphone-based remote monitoring system can support long-term management of high blood pressure and fasting blood glucose among adults receiving care in Accra, Ghana. Methods: We followed 481 adults aged 18-85 years with high blood pressure and/or type 2 diabetes who recorded home measurements through a smartphone remote-monitoring platform while attending three outpatient clinics. High blood pressure control was defined by age-specific thresholds, and fasting blood glucose control was defined as values below 7.0 millimoles per litre. We analysed changes in home measurements over time and identified factors associated with achieving control at twelve months. We also examined predictors of early blood pressure control using time-to-event analysis. Results: Both systolic and diastolic blood pressure decrease significantly within six months and remain lower at twelve months and beyond. Individuals who begin with uncontrolled values show the largest improvements. Although overall fasting blood glucose does not change significantly, those uncontrolled at baseline show a meaningful decline over time. After one year, the proportion of individuals with controlled blood pressure increases from 39 percent to 62 percent, and most participants who start uncontrolled achieve at least one controlled reading during follow-up. Conclusions: Smartphone-supported home monitoring is feasible in an urban African setting and is associated with meaningful long-term improvement in blood pressure. While reductions in fasting blood glucose are less consistent, the findings indicate that digital health tools can support chronic disease care and highlight opportunities to strengthen strategies for improving blood glucose control over time.
SN - 2730-664X
ER -