Barriers and facilitators to the use of Hypercare APK app in hypertension management: a qualitative inquiry into highly educated participants' experiences in Ilorin, Nigeria.

Introduction: Mobile health (mHealth) interventions offer promising strategies to enhance hypertension self-management; however, their real-world effectiveness depends on user engagement and contextual suitability, particularly in resource-limited settings. Evidence on highly educated participants' experiences with locally developed apps, including Hypercare APK app, remains limited. This study explored the highly educated patients' experiences with the Hypercare APK app, focusing on perceived usefulness, barriers, facilitators, and opportunities for improving its integration into hypertension care. Methods: A qualitative descriptive study was conducted among 14 adults with hypertension who had used the Hypercare APK app for at least 6 months in a tertiary hospital in Ilorin, Nigeria. Participants were purposively sampled from a digital health implementation study. Data were collected through in-depth semi-structured interviews and thematic and organization of participants analysed using Colaizzi's thematic approach. Results: Four themes identified were perceived usefulness of the application, facilitators of engagement, barriers to sustained use, and recommendations for improvement. The participants reported that medication reminders, educational messages, and self-monitoring features from the Hypercare APK app enhanced adherence and increased health awareness. The ease of use of the Hypercare APK app and access to information from the app facilitated engagement. However, structural barriers including unreliable internet connectivity, cost of mobile data, electricity challenges, and the app incompatibility limited consistent use. The participants opined that user-related barriers such as limited digital literacy, language constraints, and privacy concerns also affected its seamless use. The participants emphasised the need for offline functionality, multilingual support, simplified design, and integration into routine clinical care. Discussion: The Hypercare APK app was perceived by the participants in the tertiary hospitals in Ilorin as a valuable tool for supporting hypertension self-management in low-resource settings. On transferability, individuals with low or non-educational attainment may experience difficulties in using the app owing to poorer digital literacy. Notwithstanding, integrating mHealth interventions into existing health systems and designing contextually adaptive features are essential to enhance sustained engagement and equitable access.