Effectiveness of Self-Management Interventions to Control Blood Pressure and Treatment Adherence among Elderly with Hypertension Living Alone: A Systematic Review

Abstract

Self-management interventions play an important role in empowering older adults with hypertension to proactively manage their health and improve their overall health. However, it is still unclear to understand self-management intervention effect among older adults living alone with hypertension. To examine the effectiveness of self-management interventions (SMI) to control blood pressure and treatment adherence among elderly with hypertension living alone. The systematic search was performed across databases PubMed, ProQuest, and Google scholar in January 2024. A total of 116 articles were identified, of which 7 were included in the core review (four randomized controlled trials and three quasi-experimental). Inclusion criteria were SMI, older people 60 age and over with hypertension, and English articles. We excluded it and were unable to retrieve it as full text. The process and selection of articles used the Prisma flow chart. The review method used the JBI critical appraisal checklist to evaluate the risk of bias for RCTs and quasi experimental studies. SMI were significant for blood pressure control in hypertensive patients in two studies. All studies showed that self-management interventions were effective in reducing mean systolic and diastolic blood pressure, and positively on adherence to treatment and caring for themselves. Utilizing technology-driven SMI appears to be both suitable and effective for elderly individuals with hypertension, offering the potential to attain favourable health outcomes. Living alone may contribute to adverse impacts on both physical and mental health, elevating the risk of hypertension. Moreover, there is a need for more interventions focused on bolstering social support and mitigating social isolation, as these efforts may yield positive effects in controlling blood pressure and enhancing treatment adherence, particularly for the elderly living alone.