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Aims:

To investigate factors that moderate and mediate the effect of self-monitoring on blood pressure in hypertension

Why this is important:

Evidence from clinical trials has shown us that patients with hypertension who self-monitor their blood pressure (BP) tend to have lower BP than those patients who don’t.  However, it is unclear exactly how self-monitoring has a positive impact on blood pressure control.  It is likely that self-monitoring supports changes in behaviour in the patients, their doctors or both.  It is important to know how self-monitoring works in order to optimise its effect.

Methods:

I will use a number of methods to investigate the effects of self-monitoring seen in clinical trials, as well as how self-monitoring is used in everyday life, and how important it is in the overall management of hypertension.

  1. Systematic review and meta-analysis of the effect of self-monitoring blood pressure on medication adherence and lifestyle factors. 
  2. Self-monitoring blood pressure in hypertension, patient and provider perspectives: a systematic review and meta-analysis.
  3. Web based survey of UK primary care physicians and their use of self-monitoring in hypertension.
  4. Do patients habituate to self-monitoring, and does this explain some of the effects in trials?
  5. How does self-monitoring fit into the everyday lives of patients with hypertension, and what role does it play in the clinical encounter – semi-structured interviews and framework analysis.
  6. Patient preferences for hypertension management – discrete choice analysis (see information for those completing the online survey).

How this could benefit patients:

It is important to understand how self-monitoring achieves a positive effect so that in future we can improve the information provided to patients and doctors to promote self-monitoring, as well as tailoring future self-monitoring interventions.