Effectiveness of Self-Care Management–Based Interventions for Blood Pressure Control in Older Adults with Hypertension: A Systematic Review
TL;DR
Multicomponent interventions integrating home blood pressure monitoring, nurse-led support, and family involvement appear to be the most effective strategies for community and primary care settings.
Abstract
Aims: Hypertension is a prevalent chronic condition among older adults, yet blood pressure control remains suboptimal due to clinical complexity, limited health literacy, and treatment adherence challenges. Self-care management–based interventions have been promoted to improve patient engagement and blood pressure control. This systematic review evaluated the effectiveness of self-care management–based interventions in improving blood pressure control among older adults with hypertension. Methods: A systematic literature search was conducted in PubMed, Scopus, ScienceDirect, and Wiley Online Library following PRISMA 2020 guidelines. Randomized controlled trials and quasi-experimental studies evaluating self-care management–based interventions among older adults with hypertension were included. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool and ROBINS-I tool, while methodological quality was appraised using the Joanna Briggs Institute (JBI) tools. Data were synthesized narratively. Results: Twelve studies met the inclusion criteria: seven randomized controlled trials and five quasi-experimental studies, mostly conducted in Asia. Interventions were predominantly multicomponent, incorporating structured education, home blood pressure monitoring, nurse-led support, family involvement, physical activity, and digital health technologies. Ten studies reported significant reductions in systolic blood pressure compared with usual care, whereas findings for diastolic blood pressure were less consistent. Several studies also demonstrated improvements in medication adherence, self-care behaviors, self-efficacy, and quality of life. Conclusion: Self-care management–based interventions effectively improve blood pressure control, particularly systolic blood pressure, among older adults with hypertension. Multicomponent interventions integrating home blood pressure monitoring, nurse-led support, and family involvement appear to be the most effective strategies for community and primary care settings.