(ID: 13) Patients’ experiences of lifestyle interventions and communication strategies during hypertension clinics: a scoping review

Introduction Hypertension is a major global health problem affecting over 1.3 billion people and leading to significant morbidity, mortality, and economic burden [1]. Lifestyle interventions are critically important in hypertension management due to their effectiveness, sustainability, low-cost, and potential to reduce or eliminate the need for medication, but they are relatively under-represented in research. Little is known about patients’ experiences of lifestyle interventions during hypertension clinics, and there is concern that poor interactions could hinder lifestyle interventions and lead to worse clinical outcomes [2]. Aim This study’s aim was to identify, report, and discuss the literature evidence on lifestyle interventions during hypertension clinics from patients’ perspective, and to use this evidence to inform better clinical practice and patient care. The objectives of the research were to identify and evaluate patients’ experiences, communication strategies, information needs, and the barriers and facilitators of lifestyle interventions in hypertension clinics. Method A scoping review methodology was used to map the literature, following the six-step framework outlined by Arksey and O’Malley, and further developed by Levac et al. and Peters et al [3]. A comprehensive search of CINAHL, PubMed, Web of Science, and grey literature identified 976 studies (2013–2023). After removing duplicates and applying inclusion and exclusion criteria, 43 articles underwent full-text review, with 31 excluded, leaving 12 studies. The selection process was documented using a PRISMA flow chart and results were analysed using an inductive descriptive approach. Results 12 studies, mostly qualitative (n=11) and one Randomised Controlled Study (RCT) (n=1), were identified, which included a total of 268 adults with hypertension aged 18-90 years (116 males and 152 females). The determinants of patients’ experiences fitted into three main themes or factors: patient (personal), clinician, and hypertension clinics factors, which could act either as barriers or facilitators for lifestyle interventions. Discussion Patients generally reported positive experiences and satisfaction with lifestyle interventions in hypertension clinics, but adherence was often challenged by factors such as low motivation, time constraints, and socioeconomic or cultural influences. Success was strongly linked to personalised approaches, continuous education, and multidisciplinary support from clinicians, family, and community resources, with digital tools and psychosocial support helping to sustain long-term engagement. When it comes to effective public health interventions, vaccination has been widely acknowledged as the most significant of the past century. Predicting the most important interventions for the 21st century is difficult, but it could be argued that due to the globalisation of unhealthy lifestyles and increasing prevalence of chronic conditions, finding effective ways to support lifestyle interventions could have an extraordinary, cost-effective, and sustainable impact on health, saving millions of lives worldwide. Future research on lifestyle interventions should adopt diverse, theory-informed, and multidisciplinary approaches to examine long-term outcomes of lifestyle interventions, including the influence of patient characteristics, co-morbidities, clinicians’ perspectives, and new technologies, such as mobile health apps and Artificial Intelligence (AI). Keywords Hypertension, Lifestyle Intervention(s), Patient Experience(s)