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Patient Educ Couns. 2016 Feb;99(2):210-9. doi: 10.1016/j.pec.2015.08.026. Epub 2015 Aug 28.

Self-monitoring blood pressure in hypertension, patient and provider perspectives: A systematic review and thematic synthesis.

Author information

1
Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK. Electronic address: benjamin.fletcher@phc.ox.ac.uk.
2
Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
3
Bodleian Health Care Libraries, University of Oxford, Oxford, UK.

Abstract

OBJECTIVE:

To systematically review the qualitative evidence for patient and clinician perspectives on self-measurement of blood pressure (SMBP) in the management of hypertension focussing on: how SMBP was discussed in consultations; the motivation for patients to start self-monitoring; how both patients and clinicians used SMBP to promote behaviour change; perceived barriers and facilitators to SMBP use by patients and clinicians.

METHODS:

Medline, Embase, PsycINFO, Cinahl, Web of Science, SocAbs were searched for empirical qualitative studies that met the review objectives. Reporting of included studies was assessed using the COREQ framework. All relevant data from results/findings sections of included reports were extracted, coded inductively using thematic analysis, and overarching themes across studies were abstracted.

RESULTS:

Twelve studies were included in the synthesis involving 358 patients and 91 clinicians. Three major themes are presented: interpretation, attribution and action; convenience and reassurance v anxiety and uncertainty; and patient autonomy and empowerment improve patient-clinician alliance.

CONCLUSIONS:

SMBP was successful facilitating the interaction in consultations about hypertension, bridging a potential gap in the traditional patient-clinician relationship.

PRACTICE IMPLICATIONS:

Uncertainty could be reduced by providing information specifically about how to interpret SMBP, what variation is acceptable, adjustment for home-clinic difference, and for patients what they should be concerned about and how to act.

KEYWORDS:

Hypertension; Qualitative; Self-monitoring

PMID:
26341941
DOI:
10.1016/j.pec.2015.08.026
[Indexed for MEDLINE]

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