Outcomes Associated With a WhatsApp-Based Telehealth Education Program and Remote Follow-Up on Blood Pressure, Medication Adherence, and Self-Care: Formative Quasi-Experimental Pilot Study

BACKGROUND: Hypertension is a common chronic condition associated with substantial morbidity globally. In Jordan, many patients struggle with sustained medication adherence and self-management, highlighting a need for accessible care strategies. Low-cost platforms such as WhatsApp may support telehealth education and remote follow-up, although formative pilot data are needed to assess feasibility in this context. OBJECTIVE: This study aimed to evaluate within-participant changes in blood pressure, medication adherence, self-care behaviors, and hypertension-related knowledge from baseline to postintervention among adults with primary hypertension who participated in a formative WhatsApp-based telehealth education program with structured remote follow-up in Jordan. METHODS: A quasi-experimental, single-group pretest-posttest pilot study was conducted. In total, 40 adults (aged 28-60 years) with primary hypertension were recruited from a university hospital. The 8-week hybrid mobile health (mHealth) intervention involved training participants in home blood pressure monitoring, delivering daily educational multimedia messages via WhatsApp (covering diet, exercise, and medication), and conducting biweekly structured telephone consultations with a nurse and dietitian. Validated tools (Hill-Bone Scale, Blood Pressure Self-Care Scale, and Blood Pressure Knowledge Scale) and electronic sphygmomanometers were used at baseline and after the intervention. Data were analyzed using Wilcoxon signed-rank tests. RESULTS: All 40 participants completed the 8-week pilot and contributed paired baseline and postintervention outcome data. Postintervention scores were higher for hypertension knowledge (r=0.840; P<.001) and self-care behaviors (r=0.524; P=.001); medication adherence scores were lower, indicating better adherence (r=0.805; P<.001); and systolic (r=.434; P=.006) and diastolic blood pressure (r=.684; P<.001) were lower than those at baseline. CONCLUSIONS: This formative single-group pilot identified favorable pre-post differences in blood pressure, medication adherence, self-care behaviors, and hypertension-related knowledge among a selected sample of adults with primary hypertension. Because there was no control group, the findings do not establish intervention effectiveness or causality and should be interpreted as preliminary evidence supporting further controlled evaluation.