Engaging patients in managing hypertension: Patient experience with self-monitoring of blood pressure

​Project Description

High blood pressure represents a major risk factor for ischemic heart disease and stroke, and 1/3 of adults globally are estimated to have hypertension. But levels of treatment are low, and recent estimates show adequate control in only 13% of adults worldwide indicating a considerable delivery gap. The situation in Arab countries is especially serious, given high prevalence of blood pressure and of high body-mass index.

There is growing interest in self-monitoring of blood pressure, particularly in view of the increasing accessibility and adoption of mobile devices and wearable technologies. Self-monitoring can increase the accuracy of measurement, contributes to engaging patients in managing their condition, and is associated with better outcomes. The project investigates the potential for blood pressure self-monitoring to engage patients and overcome obstacles to regular monitoring. A situation analysis is implemented to provide contextual information about blood pressure, barriers to measurement, and the acceptability of regular monitoring; research instruments are tested to measure patient engagement and other key variables; materials are developed for patient information and counselling; and the use of self-monitoring is piloted among a sample of patients, to provide insights into patient perspectives.

The project integrates conceptual and methodological tools from health and social sciences and combines quantitative and qualitative approaches. The research is conducted in Lebanon, where hypertension prevalence (37%) is comparable to the regional average. The cultural similarities between Lebanon and other Arab countries, and the diversity in socioeconomic status, modes of health care delivery, and degree of medicalization in Lebanon, mean that the results of the project are relevant to the region as a whole.​

Research Timeline​




Carla Makhlouf Obermeyer (PI), Professor and Director, CRPH
Hala Ghattas (co-PI), Assistant Research Professor and Associate Director, CRPH
Kamal Badr (co-PI), Professor of Medicine, Associate Chair for Medical Education, Department of Internal Medicine

Research Team

Chaza Akik, Research Associate, CRPH
Christelle Akl, Research Assistant, CRPH


Harvard Medical School Center for Global Health Delivery - Dubai

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