Effects of self-management programs on blood pressure, self-efficacy, medication adherence and body mass index in older adults with hypertension: Meta-analysis of randomized controlled trials

Int J Nurs Pract. 2021 Apr;27(2):e12920. doi: 10.1111/ijn.12920. Epub 2021 Feb 16.

Abstract

Aim: To assess the effects of self-management interventions on systolic blood pressure, diastolic blood pressure, self-efficacy, medication adherence and body mass index in older adults with hypertension.

Background: Effective treatment of hypertension may require the practice of self-management behaviours. However, evidence on effects of self-management interventions on blood pressure, self-efficacy, medication adherence and body mass index in older adults with hypertension is lacking.

Design: A systematic review and meta-analysis.

Data sources: CINAHL, Cochrane Library, Embase, Ovid-Medline, PubMed, Scopus, Web of Science and other sources were searched to October 2020.

Review methods: Data were analysed using Comprehensive Meta-Analysis 2.0 and quality assessment was done using ROB 2.0. The pooled effect sizes were reported as Hedges' g values with corresponding 95% confidence intervals using a random-effects model.

Results: Twelve randomized controlled trials met our inclusion criteria. The results revealed that self-management interventions significantly decreased blood pressure and increased self-efficacy and medication adherence in older adult patients with hypertension, with no significant effect on body mass index.

Conclusions: Self-management interventions have considerable beneficial effects in older adults with hypertension. Health care providers should implement self-management interventions to strengthen the patient's role in managing their health.

Keywords: blood pressure; medication adherence; meta-analysis; nursing; older adult; self-management.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Antihypertensive Agents / therapeutic use*
  • Blood Pressure / drug effects*
  • Body Mass Index*
  • Humans
  • Hypertension / drug therapy
  • Medication Adherence*
  • Randomized Controlled Trials as Topic
  • Self Efficacy*
  • Self-Management / methods*

Substances

  • Antihypertensive Agents