Table 3.
Summary of a selected randomized controlled trial.
| Author | N | Level of education/Health literacy/Social factors | Intervention | Control | Outcomes | Any association between educational level and home BP monitoring? | Do the interventions result in better BP control? | Quality of evidence |
|---|---|---|---|---|---|---|---|---|
| Bachmann et al. [48], Switzerland, 2002 | 48 | NA | Subjects received information about the storage capabilities of HBPM | Subjects did not receive information about the storage capabilities of HBPM | Manipulation of HBPM values for the first time. Accuracy and interpretation of HBPM may be increased by using devices with a memory | Y | NA | ⊕⊕⊕ moderate |
| Binstock and Franklin [49], USA, 1988 | 120 | NA | HBPM or a combination of techniques | Education alone, contract, or pill packs alone | SBP and DBP | NA | Y | ⊕ low |
| Brenna et al. [50]. USA, 2010 | 485 | 94% ≥graduated high school | Telephonic nurse DM: educational materials, lifestyle, and diet counselling HBPM versus HBPM alone |
Light support educational program | Increase proportion with BP < 120/80 mmHg, mean systolic BP, mean diastolic BP, and frequency of HBPM after the intervention | Y | Y | ⊕⊕ low to moderate |
| DeJesus et al. [51], USA, 2009 | 54 | NA | (1) Nurse educator conducted class + HBPM (2) Nurse educator class |
Usual care | Only 20% achieved the target BP of 130/80 mmHg and there was no statistical difference in mean systolic and diastolic BP among the three groups | NA | N | ⊕ low |
| Figar et al. [52], Argentina, 2006 | 60 | Year of education | Compliance-based model includes HBPM | Patient empowerment model of education | Change in systolic BP by 24 h ABPM | NA | N | ⊕⊕ low to moderate |
| Fung et al. [53], Hong Kong, 2003 | 240 | NA | Individual education by research assistance of HBPM device operation Self-practice under supervision Checkpoints are correct |
Usual care | No significant difference in BP changes between the two groups |
Y | N | ⊕⊕⊕⊕ moderate to high |
| Green et al. [54], USA, 2008 | 778 | <12 years Some after high school 4-year college After 4-year college |
HBPM and secure patient web services training + pharmacist care management delivered through web communications | Usual care | BP level | NA | Y | ⊕⊕⊕⊕⊕ high |
| Haynes et al. [55], Canada, 1976 | 38 | Steelworkers | Taught how to measure their own BP, chart their pill-taking, taught how to tailor pill-taking to their daily habits and rituals, FU by nonprofessionals | Usual care | Improvement in drugs compliance and BP | NA | Y | ⊕⊕ low to moderate |
| Kauric-Klein and Artinian [56], USA, 2007 | 34 | Year of education | HBPM | Usual care | Improvement in SBP but not DBP | NA | Y | ⊕⊕⊕⊕ moderate to high |
| Kim et al. [57], USA, 2014 | 369 | HT knowledge self-efficacy: HT belief scale; HT health literacy scale ≤ middle school graduate; high school graduate; ≥some college | 2-hour weekly educational sessions × 6 on HBP management skill building, including health literacy training, followed by telephone counselling and HBPM for 12 months | Intervention delay | Intervention group showed improvement in mean SBP & DBP Improvement in health literacy in 12 and 18 months adherence to HT medication, self-efficacy, and HBP knowledge and less depression |
NA | Y | ⊕⊕⊕ moderate |
| Maciejewski et al. [58], USA, 2014 | 591 | Completed <12 years of education | 3 telephone-based interventions: nurse administered health behavior promotion Provider-administered medication adjustments based on HT treatment guideline Combination of both |
Usual care | Patients randomized to the combined arm had greater improvement in the proportion of BP control during and after the 18-month trial | Y | Y | Unclear |
| Magid et al. [59], USA, 2011 | 338 | High school education | Patient education including remote HBPM, reporting to an interactive voice response IVR phone system Pharmacists follow-up |
Usual care | No difference in proportion of achieving BP goal at 6 months Reduction of mean SBP and DBP |
NA | N | ⊕⊕⊕ moderate |
| Morgado et al. [60], Portugal, 2011 | 197 | Illiterate, elementary schooling, high schooling, university education | Quarter FU by a hospital pharmacist Provided patient education goal BP to achieve, medication education and recommendations to the physician regarding changes in drug therapy |
No pharmacist care | Better medication adherence, significant lower SBP and DBP were observed in the intervention group | NA | Y | ⊕⊕⊕⊕⊕ high |
| Nessman et al. [61], USA, 1980 | 52 | Noncompliance patient | HBPM education patients select BP drugs emphasizing self-help informed program | Listened to audiotape on hypertension knowledge and management nurse adjusted the drug regimens | Lower DBP better pill counts better attendance |
NA | Y | Unclear |
| Ogedegbe et al. [62], USA, 2014 | 1059 | ≤High school Some college Some graduate school |
4 modules of interactive computerized patient education HBPM Monthly lifestyle counselling clinicians CME based training, HT case round, clinical audits of patient office BP readings |
Patients and physicians received printed patient education material and hypertension treatment | Marginal significantly greater BP control in patients with moderate to good health literacy | NA | Y | ⊕⊕⊕ moderate |
| Victor et al. [63], USA, 2011 | 1022 | Black-owned barbershops </=high school college postgraduate |
10 weeks of baseline BP screening offer BP checks with haircuts promote physician check-up Sex-specific peer-based health messaging |
Received standard BP pamphlets | Improvement in hypertension control rate | NA | Y | ⊕⊕⊕ moderate |
| Yi et al. [64], USA, 2015 | 900 | Hispanic urban population Uninsured |
Received a home blood pressure monitor and training on use | Usual care | No significant difference in BP changes | NA | N | ⊕⊕ low to moderate |
| Yoo et al. [65], Korea, 2009 | 123 | NA | Ubiquitous chronic disease care system using the cellular phone Internet for overweight patients |
Usual care | Significant reduction of BP in the intervention group | NA | Y | ⊕⊕⊕ moderate |
| Zillich et al. [66], USA, 2005 | 125 | Pharmacists provided patient-specific education | Control group care + patient and physician educational program about hypertension treatment and monitoring | Provided with an HBPM device, instructed to measure BP > once daily for 1 month | More reduction of BP in the intervention group | NA | Y | ⊕⊕ low to moderate |
BP = blood pressure; DBP = diastolic blood pressure; FU = follow up; HBPM = home blood pressure monitoring; N = No; NA = not available/applicable; SBP = systolic blood pressure; Y = Yes.