Clinical Efficacy and Patient Adherence Hurdles of Remote Patient Monitoring (RPM) Frameworks in Managing Hypertension and Type 2 Diabetes: A Scoping Review

Remote patient monitoring (RPM) frameworks represent a critical paradigm shift in chronic disease management, enabling continuous physiological tracking outside traditional clinical environments; however, large-scale clinical deployment is frequently bottlenecked by operational attrition, patient compliance barriers, and therapeutic provider inertia. This scoping review maps the global evidence regarding the technical configurations, data integration architectures, and human factor friction points that dictate the implementation efficacy of RPM platforms for hypertension and type 2 diabetes. Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) consensus standards, a systematic search was executed across PubMed, Embase, and Scopus, utilizing a hybrid data extraction approach combining manual triage with a local, regular expression-driven text-mining pipeline to chart a final corpus of 400 full-text peer-reviewed source publications, yielding 701 distinct technical and operational evaluation entries. The comprehensive data charting pipeline mapped exactly 701 unique architectural and behavioral evaluation layers across the included literature. Quantitative synthesis indicated that automated upper-arm oscillometric blood pressure cuffs constituted the primary remote monitoring hardware (32.8%; n=230), while continuous glucose monitors/glucometers and wearable sensors demonstrated symmetrical distributions (11.1%; n=78 each). Ingestion architectures heavily favored automated, passive cloud-native uplinks (43.2%; n=303) over short-range active Bluetooth middleware pairing (19.4%; n=136). Implementation barrier cross-tabulation revealed that clinical workflow friction and daily routine disruption constituted the single most prevalent deployment bottleneck (27.1%; n=190). Patient-centric human factors included digital health literacy gaps (15%; n=105) and technology anxiety or alert fatigue (9.3%; n=65), while systemic provider therapeutic inertia was documented in 8.4% (n=59) of settings. Bivariate co-occurrence analysis established that operational workflow friction frequently compounded alongside digital literacy deficiencies (n=10) and clinical inertia (n=7). Ultimately, RPM deployment longevity is directly governed by technical architecture selections and the optimization of downstream clinician workflows. To minimize patient attrition and avoid technical debt, future health informatics implementations must move past isolated device deployments, prioritizing semantic interoperability via Health Level Seven (HL7) Fast Healthcare Interoperability Resources (FHIR) standards.