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Supporting self-management for people with hypertension: a meta-review of quantitative and qualitative systematic reviews
Open accessAbstract
OBJECTIVES: Globally, healthcare policy promotes supported self-management as a strategy for people with long-term conditions. This meta-review aimed to explore how people with hypertension make sense of their condition, to assess the effectiveness of supported self-management in hypertension, and to identify effective components of support. METHODS: From a search of eight databases (January 1993-October 2012; update June 2017) we included systematic syntheses of qualitative studies of patients' experiences, and systematic reviews of randomized controlled trials evaluating the impact of supported self-management on blood pressure and medication adherence. We used meta-ethnography, meta-Forest plots and narrative analysis to synthesise the data. RESULTS: Six qualitative and 29 quantitative reviews provided data from 98 and 446 unique studies, respectively. Self-management support consistently reduced SBP (by between 2 and 6 mmHg), and DBP (by between 1 and 5 mmHg). Information about hypertension and treatment, home BP monitoring (HBPM) and feedback (including telehealth) were widely used in effective interventions. Patients' perceptions of a disease with multiple symptoms contrasted with the professional view of an asymptomatic condition. HBPM, in the context of a supportive patient-professional relationship, changed perceptions of the significance of symptoms and fostered confidence in ability to self-manage hypertension. CONCLUSION: Our systematic qualitative and quantitative meta-reviews tell complementary stories. Supported self-management can improve blood pressure control. Interventions are complex and encompass a broad range of support strategies. HBPM (with or without telehealth) within the context of a supportive patient-professional partnership can bridge the gap between medical and lay perspectives of hypertension and enable effective self-management.
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“This is in line with other reviews that have shown similar improvements in hypertension [168] and type 2 diabetes self-management [169] after telemonitoring interventions.”
From Interactive Remote Patient Monitoring Devices for Managing Chronic Health Conditions: Systematic Review and Meta-analysis (2022) · cites this paper as [168]
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“Home BP monitoring [28,31,35,36,42,46,48,50], was often mediated by telehealth [27,29,32,34,37,41,43,52,53], and in some reviews also included monitoring of medication intake,weight, physical activity, and smoking [40,52].”
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Self-management education programmes by lay leaders for people with chronic conditions
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- Kung, 2010, From systematic reviews to clinical recommendations for evidence-based healthcare: validation of revised assessment of multiple systematic reviews (R-AMSTAR) for grading of clinical relevance, Open Dentistry J, 4, 84
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Smartphone Apps to Support Self-Management of Hypertension: Review and Content Analysis
Alessa, T., Hawley, M. S., Hock, E. S., & de Witte, L. (2019) · JMIR mHealth and uHealth · doi:10.2196/13645 · Cited by 170
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Metadata
- Authors
- Shahaj, O., Denneny, D., Schwappach, A., Pearce, G., Epiphaniou, E., Parke, H. L., Taylor, S. J. C., & Pinnock, H.
- Affiliations
- University of Edinburgh (GB)
- University College London Hospitals NHS Foundation Trust (GB)
- Public Health Wales (GB)
- Coventry University (GB)
- University of Nicosia (CY)
- University of Exeter (GB)
- Queen Mary University of London (GB)
- Corresponding author
- Pinnock, Hilary
- ORCID
- Venue
- Journal of Hypertension
- Published
- 2019-02
- Volume
- 37
- Issue
- 2
- Pages
- 264-279
- ISSN
- 0263-6352 (ISSN-L)
- OpenAlex
- W2883396782
- Cited by
- 110
- References
- 50
- Citations by year
- 2026: 8 · 2025: 22 · 2024: 14 · 2023: 20 · 2022: 12 · 2021: 19 · 2020: 8 · 2019: 6
- FWCI
- 1.58
- Type
- journal article
- Language
- en
- Open access
- Licence
- other-oa
- Locations
- Journal of Hypertension (publishedVersion)
- PubMed (publishedVersion)
- Pure (Coventry University) (submittedVersion, other-oa)
- Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, other-oa)
- Queen Mary Research Online (Queen Mary University of London) (submittedVersion)
- Funders
- Scottish Government
- National Institute for Health and Care Research (11/1014/04)
- Department of Health and Social Care (11/1014/04)
- Health Services and Delivery Research Programme (11/1014/04)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Keywords
- hypertension, self-management support, home blood pressure monitoring, telemedicine, medication adherence, blood pressure control, patient-professional relationship, chronic disease, self-management interventions
- MeSH terms
- Self-Management, Systematic Reviews as Topic, Blood Pressure, Blood Pressure Determination, Humans, Hypertension, Telemedicine, Medication Adherence
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