Althuwaikh, Sulaiman;
Pal, Kingshuk;
Alterkait, Bader;
Mandani, Nour;
Eastwood, Sophie V;
(2025)
Primary care clinician education interventions for improving blood pressure control for people prescribed antihypertensive treatment: a systematic review and meta-analysis.
BMJ Open
, 15
(8)
, Article e087692. 10.1136/bmjopen-2024-087692.
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Abstract
INTRODUCTION: Half of people treated for hypertension are not controlled to target; clinician education may improve effective antihypertensive use. OBJECTIVES: To systematically review and synthesise evidence from 2010 to 2024 on primary care clinician education interventions for improving blood pressure (BP) control in people on antihypertensive treatment. DESIGN: Systematic literature review. DATA SOURCES: MEDLINE, Embase and CINAHL were searched in January 2024. SETTING: Primary care. PARTICIPANTS: Primary care clinicians and patients with hypertension. INTERVENTIONS: Randomised controlled trials from 2010 to 2024 of clinician education interventions, based in primary care and reporting BP change pre-intervention versus post-intervention, were included. The primary outcome was post-intervention difference in systolic BP (SBP). The secondary outcome was change in the proportion of participants with BP controlled to target. DATA EXTRACTION AND SYNTHESIS: Abstracts were screened by four researchers; then, data were extracted from selected studies using a pre-designed proforma. Bias was assessed using the Cochrane collaboration's risk of bias tool. Results were synthesised using meta-analysis and intervention content was narratively analysed. RESULTS: A total of 73 full-text articles were screened for eligibility, of which 5 met the inclusion criteria. Meta-analysis showed no evidence of benefit (SBP reduction of -1.24 mm Hg (95% CI -3.95 to 1.47)). Of note, all bar one study reported inconclusive results. Further analysis of included studies suggested that benefit may be more likely for interventions of longer duration, involving more frequent follow-up and targeting higher risk patients. CONCLUSIONS: Current available evidence indicates clinician education interventions are unlikely to improve BP control in primary care when used in isolation.
| Type: | Article |
|---|---|
| Title: | Primary care clinician education interventions for improving blood pressure control for people prescribed antihypertensive treatment: a systematic review and meta-analysis |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1136/bmjopen-2024-087692 |
| Publisher version: | https://doi.org/10.1136/bmjopen-2024-087692 |
| Language: | English |
| Additional information: | This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
| Keywords: | Hypertension, MEDICAL EDUCATION & TRAINING, Primary Health Care, Systematic Review, Humans, Hypertension, Antihypertensive Agents, Primary Health Care, Blood Pressure, Physicians, Primary Care, Randomized Controlled Trials as Topic |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Population Science and Experimental Medicine UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Population Science and Experimental Medicine > MRC Unit for Lifelong Hlth and Ageing |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10213124 |
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