Evidence map›Paper›PMID 24454721›Full record

SynthesisPloS one2014

Patient and healthcare provider barriers to hypertension awareness, treatment and follow up: a systematic review and meta-analysis of qualitative and quantitative studies.

Rasha Khatib, Jon-David Schwalm, Salim Yusuf, R Brian Haynes, Martin McKee, Maheer Khan, Robby Nieuwlaat

Registry-linked trialAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03225586 (Prospective Urban Rural Epidemiology Study), which is not on this map. Cited by 232 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
232citing papers in PubMed, 12 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03225586 recruitingnot on this map

Prospective Urban Rural Epidemiology Study

TypeobservationalSponsorPopulation Health Research InstituteRan2002 to 2030Enrolled200,000ConditionsCardiovascular Diseases, Risk Factor, Cardiovascular, Health Behavior, Environmental Exposure
3 · Its place in the literature

Who cites it

232 citing papers in PubMed, 12 syntheses or guidelines pooled it.

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172 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Rasha KhatibPopulation Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada.
Jon-David SchwalmPopulation Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada ; Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
Salim YusufPopulation Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada ; Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada ; Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
R Brian HaynesClinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada ; Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
Martin McKeeDepartment of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Maheer KhanPopulation Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada.
Robby NieuwlaatPopulation Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada ; Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAlthough the importance of detecting, treating, and controlling hypertension has been recognized for decades, the majority of patients with hypertension remain uncontrolled. The path from evidence to practice contains many potential barriers, but their role has not been reviewed systematically. This review aimed to synthesize and identify important barriers to hypertension control as reported by patients and healthcare providers.

methodsElectronic databases MEDLINE, EMBASE and Global Health were searched systematically up to February 2013. Two reviewers independently selected eligible studies. Two reviewers categorized barriers based on a theoretical framework of behavior change. The theoretical framework suggests that a change in behavior requires a strong commitment to change [intention], the necessary skills and abilities to adopt the behavior [capability], and an absence of health system and support constraints.

findingsTwenty-five qualitative studies and 44 quantitative studies met the inclusion criteria. In qualitative studies, health system barriers were most commonly discussed in studies of patients and health care providers. Quantitative studies identified disagreement with clinical recommendations as the most common barrier among health care providers. Quantitative studies of patients yielded different results: lack of knowledge was the most common barrier to hypertension awareness. Stress, anxiety and depression were most commonly reported as barriers that hindered or delayed adoption of a healthier lifestyle. In terms of hypertension treatment adherence, patients mostly reported forgetting to take their medication. Finally, priority setting barriers were most commonly reported by patients in terms of following up with their health care providers.

conclusionsThis review identified a wide range of barriers facing patients and health care providers pursuing hypertension control, indicating the need for targeted multi-faceted interventions. More methodologically rigorous studies that encompass the range of barriers and that include low- and middle-income countries are required in order to inform policies to improve hypertension control.

Indexed as

AwarenessFollow-Up StudiesHumansHypertension

Identifiers

PMID24454721
PMCPMC3893097

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.