Digital Health Literacy in Patients With Hypertension: A Cross-Sectional Study

Melania Totaro; Giancarlo Cicolini; Alessandro Bianconi; Matteo Fiore; Anastasia Angelini; Gloria Ciampechini; Mirko Ferretti; Cesare Luigi Nonnis; Paola Quaranta; Dania Comparcini; Valentina Simonetti

doi:10.1111/jocn.17811

Digital Health Literacy in Patients With Hypertension: A Cross-Sectional Study

J Clin Nurs. 2025 May 14. doi: 10.1111/jocn.17811. Online ahead of print.

Affiliations

¹ Department of Biomedicine and Prevention, "TorVergata" University, Rome, Italy.
² Department of Innovative Technologies in Medicine & Dentistry, "G. D'annunzio" University of Chieti-Pescara, Pescara, Italy.
³ Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
⁴ AST Ascoli Piceno, Ascoli Piceno, Italy.
⁵ AST 3, Civitanova Marche, Italy.
⁶ AV2 Jesi, Ancona, Italy.
⁷ AST Ancona, Ancona, Italy.
⁸ Interdisciplinary Department of Medicine, "Aldo Moro" University of Bari, Bari, Italy.

PMID: 40369694
DOI: 10.1111/jocn.17811

Abstract

Aim: To assess Digital Health Literacy (DHL) levels among hypertensive patients.

Design: Cross-sectional study.

Methods: The study, conducted from March to August 2024 among hypertensive patients using convenience sampling, employed a 35-item questionnaire assessing: (I) sociodemographic; (II) physical activity, dietary habits, antihypertensive pharmacological treatment and medical history; (III) online health-related information knowledge and confidence; (IV) DHL, through the HLS₁₉-DIGI questionnaire with subscales on: (i) dealing with digital health information (HL-DIGI), (ii) interaction with digital resources (HL-DIGI-INT), (iii) frequency of digital device use for health (HL-DIGI-DD).

Results: Among 311 participants (mean age 63.9 years, SD = 14.8), 42.1% completed high school, 25.4% held a bachelor's degree and 22.8% were physically inactive. While 49.8% were aware of online health-related information, 28.9% were uncertain and 47.6% lacked confidence in using it for health decisions. On average, participants showed a problematic level of DHL in HL-DIGI, a sufficient level in HL-DIGI-INT, and used digital health devices just over once a week. Older age emerged as a predictor of higher online health-related knowledge and DHL, while higher education level predicted higher knowledge, confidence and DHL. Physical inactivity was associated with lower online health-related information knowledge and confidence.

Conclusions: These findings point to the need to design proactive strategies and implement targeted training and educational interventions to improve DHL in hypertensive patients.

Implications for the profession and/or patient care: Enhancing DHL levels through targeted interventions in patient care allows patients to effectively benefit from digital healthcare, achieve positive health outcomes and reduce disparities in care pathways.

Reporting method: This study adhered to the STROBE checklist for reporting.

Patient or public contribution: Patients were involved as the study population.

Protocol registration: Local Ethical Committee of the University Hospital Company of the Marche Region, Italy (protocol: 2023/279, date: 28/09/2023).

Keywords: blood pressure; digital health literacy; digital technology; hypertension; nursing; patient education; telehealth.