Determinants of regular self-monitoring of blood pressure in a digital health-based management program among Korean adults living in a remote community : a community-based observational study

Although recent efforts to integrate digital technologies have accelerated more effective and efficient hypertension management, low adherence and high dropout rates have been reported in real-world digital health programs. This study aimed to identify the factors associated with regular self-monitoring of blood pressure (SMBP) by analyzing real-world app-recorded data from a digital health-based program. Data from 186 participants enrolled in a smart online-to-offline digital healthcare program between January and December 2024 were analyzed. Sociodemographic characteristics, health status, and health behaviors of the participants and their regular SMBP performance over 12 weeks and average daily measurement frequency were analyzed. Logistic regression was used to examine the regular SMBP performance; multiple linear regression was performed on the log-transformed average measurement frequency. Females (odds ratio [OR] = 4.41), unmarried participants (OR = 5.06), and those with a monthly income of 1–2 million KRW (USD 679–1,358) (OR = 3.28) had significantly higher odds of irregular SMBP. Past or current smokers also had higher odds of poor adherence. Participants with self-rated health as “fair” showed a significantly lower measurement frequency than those who rated their health as “good” (− 0.37 times). Those residing farther from the service support center had higher odds of irregular monitoring (OR = 5.12) and fewer measurements per day (− 0.34 times) than those living nearby. SMBP adherence to digital health programs was lower among socioeconomically and medically vulnerable populations. Physical accessibility remains a significant factor, even in the digital environment. These findings highlighted the need for tailored support strategies to ensure equal participation in digital health interventions.