Network meta analysis of contributions by different healthcare practitioners in digital self care for hypertension.

Digital health interventions (DHIs) targeting blood pressure (BP) control were more effective in patient self-care than usual care (UC). However, the relative contribution of DHIs involving different healthcare practitioners (HCPs) towards BP control remained unknown. We evaluated the comparative effectiveness of patient self-care DHIs involving physicians, pharmacists, nursing staffs, or multidisciplinary teams in control of systolic blood pressure (SBP) and diastolic blood pressure (DBP) as well as patient-centred outcomes. This network meta-analysis of 69 randomised controlled trials published between January 1, 2000 to April 14, 2025 (19,837 participants) found in comparison with UC, the involvement of pharmacist care demonstrated the greatest reduction in SBP (mean difference: 6.17, 95% confidence interval: 3.08 to 9.27), while the involvement of multidisciplinary care demonstrated the greatest reduction in DBP (2.81, 1.11 to 4.51). Considering human resources for health, DHIs with nursing staff involvement performed better than their counterparts with physicians or pharmacists in reducing major cardiovascular events and all-cause deaths. Little incremental benefit towards physical activity and quality of life was observed in any HCP-involved DHIs compared to UC. Improvement in patient outcomes for DHIs with support by different HCPs varied across settings, calling for investment of upscaling or upskilling where contextually appropriate.