BACKGROUND The use of smartphone apps to assist in the self-management of hypertension is becoming increasingly common. However, although an increasing number of apps are becoming available, very few of them have the potential to be both safe and effective. In a previous study, we identified 5 apps that are potentially effective and safe, and based on the preferences of doctors and patients we selected one (Cora Health) as most suitable for use in a Saudi context. OBJECTIVE To evaluate the

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... tance and usability of the selected app in the Saudi context. METHODS This research used a mixed-methods approach with two studies: 1) a usability test involving patients in a controlled setting performing predefined tasks; and 2) a real-world usability study where patients used the app for four weeks. In the usability test, participants were asked to think aloud while performing the tasks, and an observer recorded how many tasks they completed. At the end of the real-world pilot study, participants were interviewed and the mHealth App Usability Questionnaire (MAUQ) was completed. Descriptive statistics were used to analyse quantitative data and thematic analysis was used to analyse qualitative data. RESULTS A total of 10 patients completed study 1 and 20 patients completed study 2, with a mean age of 45.5 and 51.6 respectively. Both studies showed that participants generally accepted using this app as a tool to support the self-management of hypertension and found it generally easy to use. However, some usability issues were also revealed. Participants stressed the importance of practice and training to use it more easily and proficiently. Participants had a good engagement level with 48% retention rate at the end of study 2, with most participants' usage being classed as meaningful. The most recorded data was BP, followed by stress and medication, and the most accessed feature was viewing graphs of data trends. CONCLUSIONS The app is easy to use and was generally accepted, but there are some issues that could be improved. This study suggests that there is potential for a commercially available app to be used in large-scale studies into the self-management of hypertension if the recommendations for improvements are addressed.