Effectiveness of nurse-led hypertension self-management interventions: A mixed-methods systematic review and...

This mixed-method systematic review aimed to synthesize quantitative and qualitative evidence on the effectiveness of nurse-led self-management interventions for people with hypertension.

This review, guided by the Joanna Briggs Institute (JBI) manual for evidence synthesis, was conducted by searching PubMed, CINAHL, Web of Science, Scopus, Google Scholar, and reference lists of included studies. Two reviewers independently screened, critically appraised, and extracted data from studies reporting nurse-led interventions for hypertension self-management. The JBI critical appraisal tool for randomized control trials and the mixed methods appraisal tool were used to appraise included studies. Meta-analysis was performed using Review Manager 5.4.1. The certainty of the evidence was determined using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system.

A total of 22 studies and 2,706 participants were included. Most studies were conducted in Asia, with only one study from Africa. Most interventions employed a hybrid of face-to-face and mHealth and were delivered through a blend of individual and group-based approaches. The meta-analysis showed that nurse-led self-management interventions significantly reduced systolic blood pressure (MD = -7.60; 95 %CI: -9.83, -5.36; P ≤ 0.001; 18 studies) and diastolic blood pressure (MD = -4.12; 95 %CI: -5.83, -2.41; P ≤ 0.001; 18 studies) compared to usual care in hypertension management. The qualitative evidence revealed that peer support through shared experience enhanced self-management.

Nurse-led interventions focusing on self-management are effective for improving hypertension outcomes compared with usual care. Still, the high heterogeneity suggests that factors such as population characteristics and intervention components may influence effectiveness. A combination of individual and group-based approaches offers dual benefits: tailored care and patient peer support through shared experiences.