Lived experiences of patients with Hypertension on counselling and self-management advice in community settings: A Qualitative Meta-Synthesis

The prevalence of hypertension[bv1.1] increased substantially since 1990 and reached 1.27 billion adults worldwide in 2019, with a disproportionate burden observed in low-and middle-income countries (LMICs), increasing the global public health burden, partly driven by population growth and ageing1. Long-term blood pressure management is still challenging even with the availability of adequate pharmaceutical treatment, especially in community and low-resource settings. As a result, health systems are placing a greater emphasis on lifestyle counselling and self-management recommendations, such as dietary changes, physical activity, and behaviour modification, as essential elements of hypertension treatment provided through primary care and community-based programs2. Despite the high prevalence of hypertension and the growing emphasis within health systems on hypertension counselling and self-management advice, much of the existing evidence focuses on the effectiveness of interventions and clinical outcomes3. In Low-resource community settings, there is a comparatively limited synthesis of qualitative evidence examining how adults experience, interpret, and adapt hypertension counselling and self-management advice in their daily lives. Limited understanding of lived experiences and contextual influences may lead to the implementation of hypertension counselling and self-management advice misaligned with the lived experiences of patients with hypertension, emphasising the need for a systematic review and meta-synthesis. This meta-synthesis aims to explore patients' lived experiences of counselling and self-management advice for hypertension in low-resource and community settings in India.