Interventions for improving adherence to treatment in patients with high blood pressure in ambulatory settings

Schroeder, Knut; Fahey, Tom; Ebrahim, Shah

doi:10.1002/14651858.cd004804

Cited by 213 publications

(213 citation statements)

References 54 publications

Supporting

Mentioning

193

Contrasting

Unclassified

Order By: Relevance

“…Evidence suggests that good counselling at an HIV clinic is important in improving adherence. 35 This, however, requires more time for provider-client interaction, 36 which is not always possible in clinics with a high workload and staff shortage.…”

Section: Discussionmentioning

confidence: 99%

Adherence to antiretroviral therapy, virologic failure and workload at the Rustenburg Provincial Hospital

Chabikuli

Datonye

Nachega

et al. 2010

South African Family Practice

View full text Add to dashboard Cite

SA Fam Pract 2010;52(4):350-355Background: Adherence to antiretroviral therapy (ART) is a strong predictor of progression to AIDS and death. It remains the most important potentially alterable factor that determines treatment outcomes. Methods:The study is a cross-sectional survey of self-reported adherence to ART and associated factors. The clinic had a tenfold increase in patient enrolment and a ninefold decline in staff-to-patient ratio, and the proportion of patients lost to follow-up doubled in the preceding four years.Conclusion: Adherence to ART was poor. The capacity of the clinic to manage patients adequately has declined significantly. Decentralisation of ART services to primary health care facilities should be considered.Peer reviewed.

show abstract

Section: Discussionmentioning

confidence: 99%

Adherence to antiretroviral therapy, virologic failure and workload at the Rustenburg Provincial Hospital

Chabikuli

Datonye

Nachega

et al. 2010

South African Family Practice

View full text Add to dashboard Cite

show abstract

“…These titles and abstracts were reviewed again and it was felt that it was unlikely that they would be of relevance to the final review thus, in view of this and the rapid nature of this meta-review, they were excluded on this basis. After full-text screening, there were 10 systematic reviews included in this quantitative review 99,[168][169][170][171][172][173][174][175][176] (see Figure 33).…”

Section: Systematic Reviews Identifiedmentioning

confidence: 99%

“…Half the included reviews (five) searched for all self-management support interventions (Chodosh et al, 99 Glynn et al, 171 Ebrahim, 170 Schroeder et al 174 and Takiya et al…”

Section: Systematic Reviews Identifiedmentioning

confidence: 99%

A rapid synthesis of the evidence on interventions supporting self-management for people with long-term conditions: PRISMS – Practical systematic RevIew of Self-Management Support for long-term conditions

Taylor

Pinnock

Epiphaniou

et al. 2014

Health Services and Delivery Research

337

451

View full text Add to dashboard Cite

BackgroundDespite robust evidence concerning self-management for some long-term conditions (LTCs), others lack research explicitly on self-management and, consequently, some patient groups may be overlooked.AimTo undertake a rapid, systematic overview of the evidence on self-management support for LTCs to inform health-care commissioners and providers about what works, for whom, and in what contexts.MethodsSelf-management is ‘the tasks . . . individuals must undertake to live with one or more chronic conditions . . . [including] . . . having the confidence to deal with medical management, role management and emotional management of their conditions’. We convened an expert workshop and identified characteristics of LTCs potentially of relevance to self-management and 14 diverse exemplar LTCs (stroke, asthma, type 2 diabetes mellitus, depression, chronic obstructive pulmonary disease, chronic kidney disease, dementia, epilepsy, hypertension, inflammatory arthropathies, irritable bowel syndrome, low back pain, progressive neurological disorders and type 1 diabetes mellitus). For each LTC we conducted systematic overviews of systematic reviews of randomised controlled trials (RCTs) of self-management support interventions (‘quantitative meta-reviews’); and systematic overviews of systematic reviews of qualitative studies of patients’ experiences relating to self-management (‘qualitative meta-reviews’). We also conducted an original systematic review of implementation studies of self-management support in the LTCs. We synthesised all our data considering the different characteristics of LTCs. In parallel, we developed a taxonomy of the potential components of self-management support.ResultsWe included 30 qualitative systematic reviews (including 515 unique studies), 102 quantitative systematic reviews (including 969 RCTs), and 61 studies in the implementation systematic review. Effective self-management support interventions are multifaceted, should be tailored to the individual, their culture and beliefs, a specific LTC and position on the disease trajectory, and underpinned by a collaborative/communicative relationship between the patient and health-care professional (HCP) within the context of a health-care organisation that actively promotes self-management. Self-management support is a complex intervention and although many components were described and trialled in the studies no single component stood out as more important than any other. Core components include (1) provision of education about the LTC, recognising the importance of understanding patients’ pre-existing knowledge and beliefs about their LTC; (2) psychological strategies to support adjustment to life with a LTC; (3) strategies specifically to support adherence to treatments; (4) practical support tailored to the specific LTC, including support around activities of daily living for disabling conditions, action plans in conditions subject to marked exacerbations, intensive disease-specific training to enable self-management of specific clinical tasks; and (5) social support as appropriate. Implementation requires a whole-systems approach which intervenes at the level of the patient, the HCP and the organisation. The health-care organisation is responsible for providing the means (both training and time/material resources) to enable HCPs to implement, and patients to benefit from, self-management support, regularly evaluating self-management processes and clinical outcomes. More widely there is a societal need to address public understanding of LTCs. The lack of public story for many conditions impacted on patient help-seeking behaviour and public perceptions of need.ConclusionsSupporting self-management is inseparable from the high-quality care for LTCs. Commissioners and health-care providers should promote a culture of actively supporting self-management as a normal, expected, monitored and rewarded aspect of care. Further research is needed to understand how health service managers and staff can achieve this culture change in their health-care organisations.Study registrationThis study is registered as PROSPERO CRD42012002898.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

show abstract

“…3,4 Home blood pressure measurement is a better predictor of cardiovascular disease outcomes 2,5 and target organ damage 5,6 than blood pressure measured in a physician's office. HBPM is an evidence-based strategy that has been shown to lower blood pressure, 2,7-11 improve medication adherence, 2,12,13 and promote lifestyle changes to improve blood pressure control. 2 The best evidence for the efficacy of HBPM comes from trials using HBPM in conjunction with additional support, usually nurse-or pharmacist-led follow-up of patients with uncontrolled blood pressure.…”

mentioning

confidence: 99%

Success in the Achieving CARdiovascular Excellence in Colorado (A CARE) Home Blood Pressure Monitoring Program: A Report from the Shared Networks of Colorado Ambulatory Practices and Partners (SNOCAP)

DeAlleaume

Parnes

Zittleman

et al. 2015

The Journal of the American Board of Family Medicine

View full text Add to dashboard Cite

Background: Blood pressure (BP) control among primary care patients with hypertension is suboptimal. Home BP monitoring (HBPM) has been shown to be effective but is underused.Methods: This study was a quasi-experimental evaluation of the impact of the A CARE HBPM program on hypertension control. Nonpregnant adults with hypertension or cardiovascular disease risk factors were given validated home BP monitors and reported monthly average home BP readings by Internet or phone. Patients and providers received feedback. Change in average home and office BP and the percentage of patients achieving target BP were assessed based on patient HBPM reports and a chart audit of office BPs.Results: A total of 3578 patients were enrolled at 26 urban and rural primary care practices. Of these, 36% of participants submitted >2 HBPM reports. These active participants submitted a mean of 13.5 average HBPM reports, with a mean of 19.3 BP readings per report. The mean difference in home BP between initial and final HBPM reports for active participants was ؊6.5/؊4.4 mmHg (P < .001) and ؊6.7/؊4.7 mmHg (P < .001) for those with diabetes. The percentage of active participants at or below target BP increased from 34.5% to 53.3% (P < .001) and increased 24.6% to 40.0% (P < .001) for those with diabetes. The mean difference in office BP over 1 year between participants and nonparticipants was ؊5.4/؊2.7 mmHg (P < .001 for systolic BP, P ‫؍‬ .01 for diastolic BP) for all participants and ؊8.5/؊1.5 mmHg (P ‫؍‬ .014 for systolic BP, P ‫؍‬ .405 for diastolic BP) for those with diabetes.Conclusions: An HBPM program with patient and provider feedback can be successfully implemented in a range of primary care practices and can play a significant role in BP control and decreased cardiovascular disease risk in patients with hypertension. (J Am Board Fam Med 2015;28:548 -555.)

show abstract

Interventions for improving adherence to treatment in patients with high blood pressure in ambulatory settings

Abstract: Interventions for improving adherence to treatment in patients with high blood pressure in ambulatory settings. Cochrane Database Syst Rev (2). CD004804.

Cited by 213 publications

References 54 publications

Adherence to antiretroviral therapy, virologic failure and workload at the Rustenburg Provincial Hospital

Adherence to antiretroviral therapy, virologic failure and workload at the Rustenburg Provincial Hospital

A rapid synthesis of the evidence on interventions supporting self-management for people with long-term conditions: PRISMS – Practical systematic RevIew of Self-Management Support for long-term conditions

Success in the Achieving CARdiovascular Excellence in Colorado (A CARE) Home Blood Pressure Monitoring Program: A Report from the Shared Networks of Colorado Ambulatory Practices and Partners (SNOCAP)

Contact Info

Product

Resources

About