Supported self-management consistently reduced systolic blood pressure by 2 to 6 mmHg and diastolic blood pressure by 1 to 5 mmHg in patients with hypertension.
Systematic Review
Does supported self-management improve blood pressure control and medication adherence in people with hypertension?
Supported self-management, particularly incorporating home blood pressure monitoring and a supportive patient-professional relationship, effectively reduces blood pressure in patients with hypertension.
Effect estimate: SBP reduction of 2-6 mmHg, DBP reduction of 1-5 mmHg
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.
Shahaj et al. (Thu,) conducted a systematic review in Hypertension. Supported self-management was evaluated on Systolic and diastolic blood pressure (SBP reduction of 2-6 mmHg, DBP reduction of 1-5 mmHg). Supported self-management consistently reduced systolic blood pressure by 2 to 6 mmHg and diastolic blood pressure by 1 to 5 mmHg in patients with hypertension.
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