Supporting self-management for people with hypertension: a meta-review of quantitative and qualitative systematic reviews

Orjola Shahaj, Diarmuid Denney, Anna Schwappach, Gemma Pearce, Eleni Epiphaniou, Hannah Parke, Stephanie Taylor, Hilary Pinnock

    Research output: Contribution to journalArticle

    6 Citations (Scopus)
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    Abstract

    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.

    Original languageEnglish
    Pages (from-to)264–279
    Number of pages16
    JournalJournal of Hypertension
    Volume37
    Issue number2
    Early online date30 Jul 2018
    DOIs
    Publication statusPublished - Feb 2019

    Fingerprint

    hypertension
    Self Care
    Hypertension
    management
    Telemedicine
    monitoring
    Professional-Patient Relations
    Cultural Anthropology
    Blood Pressure
    Asymptomatic Diseases
    Aptitude
    Medication Adherence
    ethnography
    medication
    Randomized Controlled Trials
    confidence
    Databases
    Disease
    Delivery of Health Care
    narrative

    Bibliographical note

    Copyright © and Moral Rights are retained by the author(s) and/ or other copyright owners. A copy can be downloaded for personal non-commercial research or study, without prior permission or charge. This item cannot be reproduced or quoted extensively from without first obtaining permission in writing from the copyright holder(s). The content must not be changed in any way or sold commercially in any format or medium without the formal permission of the copyright holders.

    Keywords

    • Hypertension
    • systematic meta-review
    • Randomised controlled trial/RCT
    • Qualitative
    • Systematic Review
    • long term conditions
    • Self-management
    • Blood Pressure
    • medication adherence
    • Telehealth
    • Meta-analysis
    • meta-ethnography
    • Qualitative synthesis

    ASJC Scopus subject areas

    • Health Professions(all)
    • Medicine(all)
    • Psychology(all)
    • Social Sciences(all)

    Cite this

    Supporting self-management for people with hypertension : a meta-review of quantitative and qualitative systematic reviews. / Shahaj, Orjola; Denney, Diarmuid; Schwappach, Anna ; Pearce, Gemma; Epiphaniou, Eleni; Parke, Hannah; Taylor, Stephanie ; Pinnock, Hilary.

    In: Journal of Hypertension, Vol. 37, No. 2, 02.2019, p. 264–279.

    Research output: Contribution to journalArticle

    Shahaj, Orjola ; Denney, Diarmuid ; Schwappach, Anna ; Pearce, Gemma ; Epiphaniou, Eleni ; Parke, Hannah ; Taylor, Stephanie ; Pinnock, Hilary. / Supporting self-management for people with hypertension : a meta-review of quantitative and qualitative systematic reviews. In: Journal of Hypertension. 2019 ; Vol. 37, No. 2. pp. 264–279.
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    AU - Parke, Hannah

    AU - Taylor, Stephanie

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