Self-monitoring blood pressure in hypertension, patient and provider perspectives: A systematic review and thematic synthesis

Fletcher, Benjamin R.; Hinton, Lisa; Hartmann-Boyce, Jamie; Roberts, Nia W.; Bobrovitz, Niklas; McManus, Richard J.

doi:10.1016/j.pec.2015.08.026

Cited by 121Blood Pressure and Hypertension StudiesPatient-Provider Communication in HealthcareMobile Health and mHealth Applications

Self-monitoring blood pressure in hypertension, patient and provider perspectives: A systematic review and thematic synthesis

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Fletcher, Benjamin R., Hinton, Lisa, Hartmann-Boyce, Jamie, Roberts, Nia W., Bobrovitz, Niklas, McManus, Richard J.·2016·Patient Education and Counseling

DOI 10.1016/j.pec.2015.08.026

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Abstract

Objective To systematically review the qualitative evidence for patient and clinician perspectives on self-measurement of blood pressure (SMBP) in the management of hypertension focussing on: how SMBP was discussed in consultations; the motivation for patients to start self-monitoring; how both patients and clinicians used SMBP to promote behaviour change; perceived barriers and facilitators to SMBP use by patients and clinicians. Methods Medline, Embase, PsycINFO, Cinahl, Web of Science, SocAbs were searched for empirical qualitative studies that met the review objectives. Reporting of included studies was assessed using the COREQ framework. All relevant data from results/findings sections of included reports were extracted, coded inductively using thematic analysis, and overarching themes across studies were abstracted. Results Twelve studies were included in the synthesis involving 358 patients and 91 clinicians. Three major themes are presented: interpretation, attribution and action; convenience and reassurance v anxiety and uncertainty; and patient autonomy and empowerment improve patient-clinician alliance. Conclusions SMBP was successful facilitating the interaction in consultations about hypertension, bridging a potential gap in the traditional patient-clinician relationship. Practice implications Uncertainty could be reduced by providing information specifically about how to interpret SMBP, what variation is acceptable, adjustment for home-clinic difference, and for patients what they should be concerned about and how to act.

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There is no unequivocal evidence that HBPV reduction may provide benefits in terms of HMOD or risk of events independently of average BP reduction, because of lack of ad hoc intervention trials.
“Also, there is no unequivocal evidence that HBPV reduction may provide benefits in terms of HMOD or risk of events independently of average BP reduction, because of lack of ad hoc intervention trials [253,254].”
From Home blood pressure monitoring: methodology, clinical relevance and practical application: a 2021 position paper by the Working Group on Blood Pressure Monitoring and Cardiovascular Variability of the European Society of Hypertension (2021) · cites this paper as [253]

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Glaser, E., Richard, C., & Lussier, M. (2017) · Patient Education and Counseling · doi:10.1016/j.pec.2017.05.022 · Cited by 22 · see citing works
SMS-Facilitated Home Blood Pressure Monitoring: A Qualitative Analysis of Resultant Health Behavior Change
Allen, M., Irizarry, T., Einhorn, J., Kamarck, T., Suffoletto, B., Burke, L. E., Rollman, B., & Muldoon, M. (2019) · Patient Education and Counseling · doi:10.1016/j.pec.2019.06.015 · Cited by 19 · see citing works
Use of Biological Feedback as a Health Behavior Change Technique in Adults: Scoping Review
Richardson, K. M., Jospe, M., Saleh, A. A., Clarke, T. N., Bedoya, A. R., Behrens, N., Marano, K. M., Cigan, L., Liao, Y., Scott, E. R., et al. (2022) · Journal of Medical Internet Research · doi:10.2196/44359 · Cited by 18 · see citing works
“The increasing accessibility of personal biosensors is a great advantage afforded to personalized health interventions as well as a notable convenience to users as compared to clinic visits [28].”
Connecting Home-Based Self-Monitoring of Blood Pressure Data Into Electronic Health Records for Hypertension Care: A Qualitative Inquiry With Primary Care Providers
Rodriguez, S., Hwang, K. O., & Wang, J. (2019) · JMIR Formative Research · doi:10.2196/10388 · Cited by 18 · see citing works
“Similar to previous studies conducted on SMBP, the majority of primary care providers in this study typically utilize SMBP to differentiate sustained hypertension from white coat hypertension [10-13].”
Result
Benefits and barriers of home blood pressure monitoring in pregnancy: perspectives of obstetric doctors from a Ghanaian tertiary hospital
Atluri, N., Beyuo, T., Oppong, S., Compton, S. D., Moyer, C., & Lawrence, E. (2023) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-023-05363-5 · Cited by 17 · see citing works
“Studies in non-pregnant patients with chronic hypertension demonstrate improvement in blood pressure control with home blood pressure monitoring [18, 19].”
Background
Factor and reliability analysis of a brief scale to measure motivation to change lifestyle for dementia risk reduction in the UK: the MOCHAD-10
Oliveira, D., Aubeeluck, A., Stupple, E., Kim, S., & Orrell, M. (2019) · Health and Quality of Life Outcomes · doi:10.1186/s12955-019-1143-8 · Cited by 17 · see citing works
Prioritizing Community-Based Intervention Programs for Improving Treatment Compliance of Patients with Chronic Diseases: Applying an Analytic Hierarchy Process
Byun, D.-H., Chang, R. S., Park, M., Son, H., & Kim, C.-B. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18020455 · Cited by 16 · see citing works
“” Second, the doctor-patient relationship should be reinforced by making the best use of the demonstration program where residents are encouraged to visit their nearest primary medical clinics for the continuity of care [87].”
Background
Implementation and use of technology-enabled blood pressure monitoring and teleconsultation in Singapore’s primary care: a qualitative evaluation using the socio-technical systems approach
Teo, S., Chew, E., Ng, D., Tang, W., Koh, G., & Teo, V. (2023) · BMC Primary Care · doi:10.1186/s12875-023-02014-8 · Cited by 15 · see citing works
“Patients and clinicians were found to be uncomfortable with the interpretation of self-monitoring measurements due to the difference between home and office readings [31].”
Background
Maternal help seeking about early warning signs and symptoms of pre-eclampsia: A qualitative study of experiences of women and their families.
Carter, W., Bick, D., Mackintosh, N., & Sandall, J. (2021) · Midwifery · doi:10.1016/j.midw.2021.102992 · Cited by 15 · see citing works
Patient use of blood pressure self-screening facilities in general practice waiting rooms: a qualitative study in the UK
Tompson, A., Grant, S., Greenfield, S., McManus, R., Fleming, S., Heneghan, C., Hobbs, F., & Ward, A. (2017) · The British journal of general practice : the journal of the Royal College of General Practitioners · doi:10.3399/bjgp17x690881 · Cited by 15 · see citing works
Self-citation
The Association of Health Literacy with High-Quality Home Blood Pressure Monitoring for Hypertensive Patients in Outpatient Settings
Fu, S., Dao, M.-C., Wong, C., & Cheung, B. (2020) · International Journal of Hypertension · doi:10.1155/2020/7502468 · Cited by 14 · see citing works
“illustrated patients’ and health care professionals’ concerns of HBPM in a qualitative review, as HBPM involved interpretation, attribution, and action [10].”
Background
Links between blood pressure and medication intake, well-being, stress, physical activity and symptoms reported via a mobile phone-based self-management support system: a cohort study in primary care
Taft, C., Hallberg, I., Bengtsson, U., Manhem, K., & Kjellgren, K. (2018) · BMJ Open · doi:10.1136/bmjopen-2017-020849 · Cited by 14 · see citing works
“No significant associations were found between symptoms (dizziness, headache and palpitations) and BP, although a near significant association (p=0.055) was found between headache and DBP.”
BackgroundInfluential
Experiences, expectations and challenges of an interactive mobile phone-based system to support self-management of hypertension: patients’ and professionals’ perspectives
Hallberg, I., Ranerup, A., Bengtsson, U., & Kjellgren, K. (2018) · Patient Preference and Adherence · doi:10.2147/ppa.s157658 · Cited by 14 · see citing works
“As shown by Fletcher et al, 33 self-monitoring of BP has the capacity to bridge a potential gap in the traditional patient–clinician relationship.”
“Be with me and stay with me”: Insights from Co-Designing a Digital Companion to Support Patients Transitioning from Hospital to Cardiac Rehabilitation
Höppchen, I., Kulnik, S., Meschtscherjakov, A., Niebauer, J., Pfannerstill, F., Smeddinck, J., Strumegger, E., Young, F., & Wurhofer, D. (2024) · Conference on Designing Interactive Systems · doi:10.1145/3643834.3661633 · Cited by 13 · see citing works
“For example, self-monitoring vital parameters such as blood pressure could increase treatment adherence, support healthy lifestyle choices, and reduce patients’ uncertainty about their disease [25].”
Background
Primary care physician beliefs and practices regarding blood pressure measurement: results from BP-CHECK qualitative interviews
Hsu, C. W., Hansell, L., Ehrlich, K., Munson, S. A., Anderson, M., Margolis, K., McClure, J. B., Hall, Y., Thompson, M. J., Joseph, D., et al. (2023) · BMC Primary Care · doi:10.1186/s12875-022-01950-1 · Cited by 13 · see citing works
“’s themes regarding the concerns that PCPs have with self-monitored BP, including difficulties interpreting variable BP readings and reconciling them against clinic measurements as well as perhaps unfounded worries that HBPM causes patients to become overly anxious about their BP [10].”
Background
Home blood pressure monitoring and adherence in patients with hypertension on primary prevention treatment: a survey of 1026 patients in general medicine in the Auvergne region
Trefond, J., Hermet, L., Lambert, C., Vaillant-Roussel, H., Pouchain, D., Menini, T., Pereira, B., & Vorilhon, P. (2022) · BMC Primary Care · doi:10.1186/s12875-022-01725-8 · Cited by 13 · see citing works
“For two reviews of the literature, the benefit was moderate [6, 7].”
Background
Patients’ and Providers’ Perspectives on and Needs of Telemonitoring to Support Clinical Management and Self-care of People at High Risk for Preeclampsia: Qualitative Study
Aquino, M., Griffith, J., Vattaparambil, T., Munce, S., Hladunewich, M., & Seto, E. (2021) · JMIR Human Factors · doi:10.2196/32545 · Cited by 13 · see citing works
Assessing Data Adequacy for High Blood Pressure Clinical Decision Support: A Quantitative Analysis
Dorr, D. A., D'Autremont, C., Pizzimenti, C. L., Weiskopf, N. G., Rope, R. W., Kassakian, S. Z., Richardson, J. E., Mcclure, R., & Eisenberg, F. (2021) · Applied Clinical Informatics · doi:10.1055/s-0041-1732401 · Cited by 13 · see citing works
A cluster‐randomized study on the Risk Assessment and Management Program for home blood pressure monitoring in an older population with inadequate health literacy
Fu, S., Dao, M.-C., Luk, W., Lam, M., Ho, I., Cheung, S.-K., Wong, C., & Cheung, B. (2020) · The Journal of Clinical Hypertension · doi:10.1111/jch.13987 · Cited by 13 · see citing works
Prescribing of Electronic Activity Monitors in Cardiometabolic Diseases: Qualitative Interview-Based Study
Bellicha, A., Macé, S., & Oppert, J. (2017) · Journal of Medical Internet Research · doi:10.2196/jmir.8107 · Cited by 13 · see citing works
“Such risks have been described in patients using blood glucose and blood pressure self-monitoring devices [26,27].”
Background
Blood Pressure Checks for Diagnosing Hypertension: Health Professionals' Knowledge, Beliefs, and Practices
Green, B., Anderson, M., Ehrlich, K., Hall, Y., Hansell, L., Hsu, C. W., Joseph, D., Margolis, K., McClure, J. B., Munson, S. A., et al. (2022) · Journal of the American Board of Family Medicine · doi:10.3122/jabfm.2022.02.210318 · Cited by 12 · see citing works
Preventing the Next Pandemic: The Case for Investing in Circulatory Health – A Global Coalition for Circulatory Health Position Paper
Ferat, L. R., Forrest, R., Sehmi, K., Santos, R. D., Stewart, D., Boulton, A., Jiménez, B. Y., Riley, P. F., Burger, D., Jones, E., et al. (2021) · Global Heart · doi:10.5334/gh.1077 · Cited by 12 · see citing works
Patient and Health Professional Perceptions of Telemonitoring for Hypertension Management: Qualitative Study
Baratta, J., Brown-Johnson, C., Safaeinili, N., Rosas, L. G., Palaniappan, L., Winget, M., & Mahoney, M. (2021) · JMIR Formative Research · doi:10.2196/32874 · Cited by 10 · see citing works
“Remote BP monitoring has also been shown to empower patients in relation to managing their hypertension [14] and improve the patient-clinician alliance [15].”
Background
Evaluating relationships between lung cancer stigma, anxiety, and depressive symptoms and the absence of empathic opportunities presented during routine clinical consultations
Williamson, T. J., Ostroff, J., Martin, C. M., Banerjee, S. C., Bylund, C., Hamann, H., & Shen, M. (2020) · Patient Education and Counseling · doi:10.1016/j.pec.2020.08.005 · Cited by 10 · see citing works
Using Speculative Design to Understand Preferred Futures for the Design and Use of Tracking Data in U.S. College Sport Teams
Kolovson, S., So, S., & Munson, S. A. (2024) · Proc. ACM Hum. Comput. Interact. · doi:10.1145/3641028 · Cited by 9 · see citing works
“However, for patients and clinicians unfamiliar with seeing this many measures (compared to, e.g., measures collected in the clinic), variability and lack of guidance in how to interpret it has instead increased treatment uncertainty [29].”
Background
Barriers and facilitators to self-measured blood pressure monitoring among US-resettled Arab refugees with hypertension: a qualitative study
Bridi, L., Albahsahli, B., Bencheikh, N., Baker, D. A., Godino, J., O'Laughlin, K., & Al-Rousan, T. (2023) · BMC Primary Care · doi:10.1186/s12875-023-02215-1 · Cited by 9 · see citing works
“(Male, 68).”
Acceptability and psychological impact of out-of-office monitoring to diagnose hypertension: an evaluation of survey data from primary care patients.
Tompson, A., Ward, A., McManus, R., Perera, R., Thompson, M. J., Heneghan, C., & Nunan, D. (2019) · The British journal of general practice : the journal of the Royal College of General Practitioners · doi:10.3399/bjgp19x702221 · Cited by 9 · see citing works
Self-citation
Uncertainties in BP management in dialysis patients
Doulton, T., Swift, P., Murtaza, A., & Dasgupta, I. (2020) · Seminars in dialysis · doi:10.1111/sdi.12880 · Cited by 8 · see citing works
Healthcare practitioner views and experiences of patients self-monitoring blood pressure: a vignette study
Andrews, J., Weiner, K., Will, C. M., Henwood, F., & Dickson, J. (2020) · BJGP open · doi:10.3399/bjgpopen20x101101 · Cited by 7
“Their study and other prior work focuses largely on managing care once a patient has obtained a monitor, excluding guidance provided prior to this point.(8,9) Some work has additionally explored the potential of new technologies (for example, smartphone apps) for measuring blood pressure in primary care,(10) although…”
Background
Differences in knowledge of hypertension by age, gender, and blood pressure self-measurement among the Israeli adult population✰.
Melnikov, S. (2019) · Heart & lung : the journal of critical care · doi:10.1016/j.hrtlng.2019.02.001 · Cited by 7 · see citing works
Using a smartphone app to identify signs of pre-eclampsia and/or worsening blood pressure
Sheehan, E., Khalil, A., & Kay, L. (2019) · British Journal of Midwifery · doi:10.12968/bjom.2019.27.2.92 · Cited by 7 · see citing works
Clinical Decision Support Systems Using Home Blood Pressure Readings to Manage Patients With Hypertension: Scoping Review
Moosa, A. S., Seng, J. J. B., & Ng, C. J. (2025) · Journal of Medical Internet Research · doi:10.2196/75551 · Cited by 7 · see citing works
Factors influencing adoption of self-monitoring of blood pressure among hypertensive patients in primary healthcare in Vietnam: a cross-sectional facility-based study
Nguyen, G. H., Nguyen, L. T., Anh, L. T. K., Plancikova, D., Rusnakova, V., Nguyen, T. T., & Koot, J. (2025) · BMC Primary Care · doi:10.1186/s12875-025-02871-5 · Cited by 6
“Other factors such as patients’ beliefs about the importance of self-monitoring and their confidence in their ability to perform the task may also play a role [20].”
Self-monitoring blood pressure in pregnancy: evaluation of women’s experiences of the BUMP trials
Chisholm, A., Tucker, K., Crawford, C., Green, M., Greenfield, S., Hodgkinson, J., Lavallee, L., Leeson, P., Mackillop, L., Mccourt, C., et al. (2024) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-024-06972-4 · Cited by 6 · see citing works
Self-citation
Self-monitoring blood pressure in Pregnancy: Evaluation of health professional experiences of the BUMP trials.
Chisholm, A., Tucker, K., Crawford, C., Green, M., Greenfield, S., Hodgkinson, J., Lavallee, L., Leeson, P., Mackillop, L., Mccourt, C., et al. (2024) · Pregnancy Hypertension · doi:10.1016/j.preghy.2024.01.134 · Cited by 6 · see citing works
Self-citation
‘The plural of silo is not ecosystem’: Qualitative study on the role of innovation ecosystems in supporting ‘Internet of Things’ applications in health and care
Reidy, C., A'Court, C., Jenkins, W., Jani, A., Ramos, A., Morys-Carter, M., & Papoutsi, C. (2023) · Digital Health · doi:10.1177/20552076221147114 · Cited by 6 · see citing works
“At system level, the local area was seen as geared more towards academic needs and timelines, which did not always match the adapt-ability and fast turnaround times start-ups and established companies needed (see Quote 34).”
Background
Primary care doctors’ views on self-monitoring of blood pressure and self-titration among patients with uncontrolled hypertension in Spain. The ADAMPA trial focus group study.
Marco-Moreno, I., Martínez-Ibáñez, P., Avelino-Hidalgo, E., Bellot-Pujalte, L., Barreira-Franch, I., Martinez-Ibañez, L., Escrig-Veses, M., Giménez-Loreiro, M., Bóveda-García, M., Calleja-del-Ser, M., et al. (2020) · BJGP open · doi:10.3399/bjgpopen20x101062 · Cited by 6 · see citing works
Challenges and strategies for hypertension management: qualitative analysis of small primary care practices with varying blood pressure control.
Smolen, J., Wang, J. J., & Anane, S. (2019) · Family Practice · doi:10.1093/fampra/cmz004 · Cited by 6 · see citing works
Multi-trajectory modeling of home blood pressure telemonitoring utilization among hypertensive patients in China: A latent class growth analysis
Ye, T., Zhang, P., Ouyang, Z.-L., Yang, J., Xu, C., Pan, Z., Wu, Z.-Z., Zhang, L., & Li, B.-Y. (2018) · Int. J. Medical Informatics · doi:10.1016/j.ijmedinf.2018.09.005 · Cited by 6 · see citing works
Patient experience of home and waiting room blood pressure measurement: a qualitative study of patients with recently diagnosed hypertension
Tompson, A., Schwartz, C., Fleming, S., Ward, A., Greenfield, S., Grant, S., Hobbs, F., Heneghan, C., & McManus, R. (2018) · The British journal of general practice : the journal of the Royal College of General Practitioners · doi:10.3399/bjgp18x699761 · Cited by 6
Self-citation
Digital Self-monitoring of Multiple Sclerosis: Interview Study With Dutch Health Care Providers on the Expected New Configuration of Roles and Responsibilities
Wendrich, K., & Krabbenborg, L. (2021) · JMIR mHealth and uHealth · doi:10.2196/30224 · Cited by 5 · see citing works
Home blood-pressure measurement for the diagnosis and monitoring of arterial hypertension by French general practitioners: a cross-sectional survey in the Auvergne region
Xavier, M., Jéromine, T., Guillaume, P., Gilles, T., Sylvaine, B.-G., Aurélien, M., & Philippe, V. (2021) · BMC Family Practice · doi:10.1186/s12875-020-01358-9 · Cited by 5 · see citing works
“In other countries, HBPM seems to be more likely to be used for monitoring than for diagnosis compared to our survey [7, 9].”
MethodResult
Effect of Education for Hypertensive Patients with Correctly Performed Self-Blood Pressure Monitoring (SBPM)
Dymek, J., Golda, A., Polak, W., Lisowski, B., & Skowron, A. (2019) · Pharmacy · doi:10.3390/pharmacy7030075 · Cited by 5 · see citing works
Revisão Sistemática sobre a Eficácia de Metas Intensivas do Tratamento Anti-Hipertensivo: Recomendação da Sociedade Brasileira de Cardiologia (SBC)
Brandão, A. A., Rodrigues, C. I. S., Bortolotto, L., Luna, L. C., Barros, B., Neves, M., Moura, A. F. D. S., Plavnik, F., Drager, L., Moreira, O., et al. (2025) · Arquivos Brasileiros de Cardiologia · doi:10.36660/abc.20240761 · Cited by 4 · see citing works
Perceived, objective, and applied numeracy among pregnant women engaged in home blood pressure monitoring in Ghana
Lawrence, E., Irani, S., Nartey, B. A., Collins, B., Segbedzi-Rich, E., Pangori, A., Beyuo, T., Moyer, C. A., Lori, J. R., & Oppong, S. (2025) · AJOG Global Reports · doi:10.1016/j.xagr.2025.100468 · Cited by 4 · see citing works
Exploring primary care physicians’ challenges in using home blood pressure monitoring to manage hypertension in Singapore: a qualitative study
Moosa, A., Oka, P., & Ng, C. J. (2024) · Frontiers in Medicine · doi:10.3389/fmed.2024.1343387 · Cited by 4 · see citing works
Effects of an interactive web-based support system via mobile phone on preference-based patient participation in patients living with hypertension – a randomized controlled trial in primary care
Vestala, H., Bendtsen, M., Midlöv, P., Kjellgren, K., & Eldh, A. (2024) · Scandinavian Journal of Primary Health Care · doi:10.1080/02813432.2023.2301567 · Cited by 4 · see citing works
“Different self-monitoring systems for hypertension are often used in clinical trials or in the development of interventions, but rarely in standard hypertensive practice [32].”
Background
Healthcare provider’s perspectives on home blood pressure management in Peru and Cameroon: Findings from the BPMONITOR study
Al-Rousan, T., Awad, M., Pesantes, M., Kandula, N., Huffman, M., Miranda, J. J., Vidal-Pérez, R., Dzudié, A., & Anderson, C. A. M. (2023) · Preventive medicine reports · doi:10.1016/j.pmedr.2023.102179 · Cited by 4 · see citing works
“This is consistent with findings from highincome countries (Fletcher et al., 2016).”
Result
Patient expectations and preferences for community-based hypertension classes with implications for action.
Bulgin, D., Biola, H., Whitney, C., Bakovic, M., Kang, Y., Raman, R., Eck, C. V., Caesar, A., Chaplin, J., Eisenson, H., et al. (2022) · Worldviews on Evidence-Based Nursing · doi:10.1111/wvn.12550 · Cited by 4 · see citing works
Motivation and willingness to increase physical activity for dementia risk reduction: Cross-Sectional UK survey with people aged 50 and over
Oliveira, D., Knight, H., Jones, K. A., Ogollah, R., & Orrell, M. (2021) · Aging & Mental Health · doi:10.1080/13607863.2021.1984393 · Cited by 4 · see citing works
“In other chronic conditions, motivation is associated with healthy lifestyle change and adherence to treatment regimens (Fletcher et al., 2016; Kähkönen et al., 2015), even though not all people who are motivated may in fact be more engaged with physical activity.”
Background
Home Blood Pressure Monitoring: Cost-Effectiveness, Patients’ Preference and Barriers for Clinical Use
Muntner, P., McManus, R., Shimbo, D., de la Sierra, A., & Myers, M. (2019) · Updates in Hypertension and Cardiovascular Protection · doi:10.1007/978-3-030-23065-4_9 · Cited by 4 · see citing works
Self-citation
Nutritional status, glycaemic control and barriers to treatment compliance among patients with type 2 diabetes attending public primary health clinics in Maseru, Lesotho
van den Berg, L., Mokhehle, M., & Raubenheimer, J. (2019) · Journal of Endocrinology Metabolism and Diabetes of South Africa · doi:10.1080/16089677.2019.1649341 · Cited by 4 · see citing works
Self-monitoring of blood pressure during pregnancy: an observational study in the obstetrical waiting room
Lihme, F., Madsen, M., & Lykke, J. (2017) · Blood Pressure Monitoring · doi:10.1097/mbp.0000000000000277 · Cited by 4 · see citing works
A User Typology for Digital Health Self-Management Technologies: A Qualitative Study of the Long-term User Experiences of Older Adults with a Digital Self-Management Platform for Multimorbidity (ProACT)
Polak, S., Smitt, M. S., Jacobs, A., van Leeuwen, C., Doyle, J., Cullen-Smith, S., & Dinsmore, J. (2025) · Journal of Healthcare Informatics Research · doi:10.1007/s41666-024-00183-4 · Cited by 3 · see citing works
The Logics of Invited and Uninvited Material Participation
Weiner, K., Henwood, F., Andrews, J., Will, C. M., & Williams, R. (2022) · Science & Technology Studies · doi:10.23987/sts.112027 · Cited by 3 · see citing works
“It was notable that a pedagogic narrative about blood pressure self-monitoring did not feature in our focus groups, although we discerned this as a possibility within the clinical literature (e.g., Fletcher et al., 2016).”
Background
Blood Pressure Awareness and Knowledge of Cardio-Cerebrovascular Diseases in South Korean Women with Hypertension
Jeong, Y. (2021) · Healthcare · doi:10.3390/healthcare9030360 · Cited by 3
“This may mean that those diagnosed with HTN and taking medication, measure their BP more frequently to assess the medication effects [53,55].”
BackgroundInfluential
Systematic Review of the Effectiveness of Intensive Antihypertensive Treatment Goals: Brazilian Society of Cardiology (SBC) Recommendation
Brandão, A. A., Rodrigues, C. I. S., Bortolotto, L., Luna, L. C., Barros, B., Neves, M., Moura, A. F. D. S., Plavnik, F., Drager, L., Moreira, O., et al. (2025) · Arquivos Brasileiros de Cardiologia · doi:10.36660/abc.20240761i · Cited by 2 · see citing works
“…adherence, such as simplifying dosing regimens (prescribing medications that require fewer doses per day), 37 using single-pill combinations, 38 encouraging patients to monitor their BP at home, 39 and fostering a close relationship between healthcare professionals and patients, 40 can…”
Study protocol: Collaboration Oriented Approach to Controlling High blood pressure (COACH) in adults – a randomised controlled trial
Dorr, D., Montgomery, E., Ghumman, A., Michaels, L., Rolbiecki, A. J., Canfield, S. M., Shaffer, V. A., Johnson, B., Lockwood, M., Ghosh, P., et al. (2024) · BMJ Open · doi:10.1136/bmjopen-2024-085898 · Cited by 2 · see citing works
Exploring perceptions and operational considerations for use of a smartphone application to self-monitor blood pressure in pregnancy in Lombok, Indonesia: protocol for a qualitative study
Tamrat, T., Setiyawati, Y. D., Barreix, M., Gayatri, M., Rinjani, S. O., Pasaribu, M. P., Geissbuhler, A., Shankar, A. H., & Tunçalp, Ö. (2023) · BMJ Open · doi:10.1136/bmjopen-2023-073875 · Cited by 2 · see citing works
Hipertansiyon Hastalarının Aleksitimi Düzeyleri İle Öz Etkililikleri Arasındaki İlişki
Metin, T., Semerci, V., & Özdemir, S. Ç. (2023) · Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi · doi:10.34087/cbusbed.1315499 · Cited by 2 · see citing works
Inter-individual variability in Self-Monitoring of Blood Pressure using Consumer-Purchased Wireless Devices
Zheng, Y., Zhang, Y., Huang, H., Tison, G. H., Burke, L. E., Blecker, S., Dickson, V., Olgin, J., Marcus, G., & Pletcher, M. (2023) · Nursing Research · doi:10.1097/nnr.0000000000000654 · Cited by 2 · see citing works
“Most reported studies related to engagement with SMBP have been short term, with the majority lasting ≤6 months (Burke et al., 2015; Fletcher et al., 2016; Kaplan et al., 2017; Ye et al., 2018) and very few studies extending beyond 12months (Ostchega et al., 2017; Waalen et al., 2019).”
BackgroundInfluential
Healthcare Demand and the Adequacy of Its Impact on Patient Satisfaction and Quality Outcomes: A Structural Equation Modeling Approach
Mohammad, A., Alolayyan, M., Mohammad, S., Al-Daoud, K., Oraini, B. A., Vasudevan, A., & Hunitie, M. (2025) · Journal of Posthumanism · doi:10.63332/joph.v5i1.654 · Cited by 1
“This improvement is characterized by a higher demand of healthcare services (Fletcher et al., 2016).”
Implementing Remote Patient Monitoring to Improve Hypertension Control in a Primary Care Network: Rationale and Design of the Monitor-BP Cluster Randomized Trial
Liyanage-Don, N. A., Phillips, E., Schwartz, J., Chang, M. J., Lopez-Sanchez, M.-J., West, H., Bellows, B. K., Singer, J., Dandan, N., Qian, M., et al. (2025) · American Heart Journal · doi:10.1016/j.ahj.2025.04.005 · Cited by 1 · see citing works
Providers’ Perspective on the Feasibility of Digital Self-Management of Blood Pressure in Refugees: Mixed Methods Study
Gonzalez, C., Real, M., Ahmadi, N., Aljenabi, R., Bridi, L., Makarem, N., Godino, J., & Al-Rousan, T. (2024) · JMIR Human Factors · doi:10.2196/66176 · Cited by 1 · see citing works
“Given the ongoing self-management demanded by chronic conditions such as hypertension, self-titration could provide crucial support for clinics in efficiently caring for their patients and decreasing clinic visits [7,21,27].”
Effect of a Multilevel Intervention on Racial Disparities in Medication Adherence: An Analysis of the Rich Life Project.
Meche, A., Cooper, L. A., Mehta, H., Alexander, G. C., & Jackson, J. W. (2026) · Journal of general internal medicine · doi:10.1007/s11606-026-10951-0
Trends in adherence with a home blood pressure monitoring intervention among pregnant women in Ghana: A prospective cohort study.
Lawrence, E., Sepenu, P., Nartey, B. A., Buxton, C., Pangori, A., Harfmann, R., Compton, S. D., Beyuo, T., Moyer, C. A., Lori, J. R., et al. (2026) · International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · doi:10.1002/ijgo.71279
Effect of Health Literacy on use of a Virtual Coach to Promote Home Blood Pressure Monitoring
Odo, C., Mrkva, A., Shepherd, E., Davis, N., Kaleida, B., Muldoon, M. F., & Magnani, J. W. (2026) · The Journal of Clinical Hypertension · doi:10.1111/jch.70320
“Successful HBPM requires patients to understand and follow measurement instructions, incorporate monitoring into their routine self-management, and accurately record and interpret results [ 25 ].”
Strategies for improving home blood pressure monitoring among pregnant women with low adherence in Ghana
Oppong, A. Y., Harfmann, R., Nartey, B. A., Buxton, C., Moyer, C. A., Lori, J. R., Oppong, S., & Lawrence, E. (2026) · Pregnancy · doi:10.1002/pmf2.70294
“Successful home BP monitoring relies on consistent adherence, accurate recognition of elevated readings, and prompt communication with healthcare providers for management [7, 8].”
The ongoing quest for the independent patient: an interview study on healthcare professionals’ perspectives on integrating self-monitoring of blood pressure in hypertension care
Kelemit, E., Halmambetova, E., Nilsson, E., Fagerström, C., & Ljungholm, L. (2026) · BMC Family Practice · doi:10.1186/s12875-026-03244-2
“The present study also suggests that SMB may provoke stress and anxiety in patients, a side effect that is well-documented in the literature [18, 19] (Halmambe-tova E, Nilsson E, Fagerström C, Årestedt K, Bjöersdorff M, Ljungholm L: Self-monitoring of blood pressure and self-assessment of…”
Involving End Users in Co-Designing Mobile Health Interventions for Hypertension Self-Management: Formative Study
Johnson, A. E., Nair, P., Behara, D., Aranda-Hernadez, A., Bey, J., Harrington, C. N., Miller, E., Peek, M. E., Kitsiou, S., & Magnani, J. (2026) · JMIR Formative Research · doi:10.2196/77631
“Such features would likely lead to higher confidence in using mHealth, thus supporting patient autonomy as well as patient-clinician partnerships [51].”
Applying behavior change theory to intervention design: promoting clinic-level implementation of self-measured blood pressure monitoring in safety net primary care settings
Tieu, L., Khoong, E. C., Shah, N. D., Gosdin, M., Wang, S., Sharma, A. E., Abtahi, N., Stern, R. J., Zhou, C., Sarkar, U., et al. (2026) · Translational Behavioral Medicine · doi:10.1093/tbm/ibaf094
“Overall, because the motivation of clinical teams and patients to engage in SMBP-related processes are likely interlinked [69–71], our study also focuses specifically on the cascading effects on patient-level engagement in SMBP [42].”
Pemberdayaan Majelis Taklim Melalui Edukasi Psikospiritual dalam Pengendalian Hipertensi dan Pencegahan Stroke
Asnaniar, W., Asfar, A., Siokal, B., Lailan, N., & Zaekil, A. (2025) · Journal of Community Development · doi:10.47134/comdev.v6i2.1779

Authors: Fletcher, B. R., Hinton, L., Hartmann-Boyce, J., Roberts, N. W., Bobrovitz, N., & McManus, R. J.
Affiliations: University of Oxford (GB)
Corresponding author: Fletcher, Benjamin R.
ORCID: Fletcher, Benjamin R.
Hinton, Lisa
Roberts, Nia W.
Bobrovitz, Niklas
McManus, Richard J.
Venue: Patient Education and Counseling
Publisher: Elsevier BV
Published: 2016-02
Volume: 99
Issue: 2
Pages: 210-219
ISSN: 0738-3991 (ISSN-L)
DOI: 10.1016/j.pec.2015.08.026
OpenAlex: W1127212170
Cited by: 121
References: 29
Citations by year: 2026: 6 · 2025: 14 · 2024: 13 · 2023: 15 · 2022: 10 · 2021: 16 · 2020: 9 · 2019: 14 · 2018: 12 · 2017: 7 · 2016: 5
FWCI: 1.38
Type: journal article
Language: en
Open access: green
www.repository.cam.ac.uk
Licence: cc-by-nc-nd
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Patient Education and Counseling (publishedVersion)
PubMed (publishedVersion)
University of Birmingham Research Portal (University of Birmingham) (submittedVersion)
Apollo (University of Cambridge) (submittedVersion, cc-by-nc-nd)
Apollo
Funders: National Institute for Health Research (NIHR)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
Keywords: hypertension, patient perspectives, clinician perspectives, patient-clinician relationship, home blood pressure monitoring, behavior change, patient empowerment
MeSH terms: Attitude of Health Personnel, Blood Pressure, Female, Humans, Hypertension, Health Knowledge, Attitudes, Practice, Male, Motivation, Blood Pressure Monitoring, Ambulatory, Self Efficacy, Personal Autonomy

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Self-monitoring blood pressure in hypertension, patient and provider perspectives: A systematic review and thematic synthesis

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