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

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


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.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Attitude of Health Personnel*
  • Blood Pressure / physiology*
  • Blood Pressure Monitoring, Ambulatory*
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Hypertension / diagnosis*
  • Hypertension / physiopathology
  • Hypertension / therapy
  • Male
  • Motivation*
  • Personal Autonomy*
  • Self Efficacy