Key result
Education, team-based care, and SMS reminders emerge as top interventions improving hypertension care retention.
Why the study?
Regular engagement over time in hypertension care is a crucial but understudied step in optimizing patient outcomes.
What interventions and contextual factors improve retention in care for patients with hypertension in primary care?
Systematic Review
Yes
What interventions and contextual factors improve retention in care for patients with hypertension in primary care?
Multilevel interventions, particularly those utilizing non-physician personnel, education, team-based care, and SMS reminders, are commonly used strategies to improve retention in hypertension care.
Supports adoption of education, team-based care, and SMS reminders for hypertension retention; extends evidence on multilevel strategies in primary care.
BACKGROUND: Regular engagement over time in hypertension care, or retention, is a crucial but understudied step in optimizing patient outcomes. This systematic review leverages a hermeneutic methodology to identify, evaluate, and quantify the effects of interventions and contextual factors for improving retention for patients with hypertension. METHODS: We searched for articles that were published between 2000 and 2022 from multiple electronic databases, including MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, clinicaltrials.gov, and WHO International Trials Registry. We followed the latest version of the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guideline to report the findings for this review. We also synthesized the findings using a hermeneutic methodology for systematic reviews, which used an iterative process to review, integrate, analyze, and interpret evidence. RESULTS: From 4686 screened titles and abstracts, 18 unique studies from 9 countries were identified, including 10 (56%) randomized controlled trials (RCTs), 3 (17%) cluster RCTs, and 5 (28%) non-RCT studies. The number of participants ranged from 76 to 1562. The overall mean age range was 41-67 years, and the proportion of female participants ranged from 0% to 100%. Most (n = 17, 94%) studies used non-physician personnel to implement the proposed interventions. Fourteen studies (78%) implemented multilevel combinations of interventions. Education and training, team-based care, consultation, and Short Message Service reminders were the most common interventions tested. CONCLUSIONS: This review presents the most comprehensive findings on retention in hypertension care to date and fills the gaps in the literature, including the effectiveness of interventions, their components, and contextual factors. Adaptation of and implementing HIV care models, such differentiated service delivery, may be more effective and merit further study. REGISTRATION: CRD42021291368. PROTOCOL REGISTRATION: PROSPERO 2021 CRD42021291368. Available at: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=291368.
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Ye et al. (2024) conducted a systematic review in Hypertension. Interventions to improve retention in care (e.g., education, team-based care, SMS reminders) was evaluated on Retention in hypertension care. A systematic review of 18 studies identified education, team-based care, consultation, and SMS reminders as the most common interventions to improve retention in hypertension care.
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