Engaging Patients in Managing Hypertension: Patient Experience with Self-monitoring of Blood Pressure
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 investigated the potential for blood pressure self-monitoring to engage patients in managing their hypertension. A situation analysis was implemented to provide contextual information about blood pressure, barriers to measurement, and the acceptability of regular monitoring; research instruments were tested to measure patient engagement and other key variables; materials were developed for patient information and counselling; and the use of self-monitoring was piloted among a sample of patients, to provide insights into patient perspectives.
The project integrated conceptual and methodological tools from health and social sciences and combined quantitative and qualitative approaches. The research was 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.
Research Timeline: 2016-2020
- 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
- Chaza Akik, Research Associate, CRPH
- Christelle Akl, Research Assistant, CRPH
- Lara Ghandour, Research Assistant, AUBMC
- Nadine El Rashidi, Research Assistant, CRPH
- Sara Abou Fakher, Research Assistant, CRPH
- Harvard Medical School Center for Global Health Delivery - Dubai