The Long and Winding Road: A Systematic Literature Review Conceptualising Pathways for Hypertension Care and Control in Low- and Middle-Income Countries.
The Long and Winding Road: A Systematic Literature Review Conceptualising Pathways for Hypertension Care and Control in Low- and Middle-Income Countries.
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DOI：
10.34172/ijhpm.2020.105
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发表时间：
2022-03-01
影响因子：
3.5
通讯作者：
Balabanova, Dina
中科院分区：
文献类型：
--
作者：
Brathwaite, Rachel;Hutchinson, Eleanor;McKee, Martin;Palafox, Benjamin;Balabanova, Dina
背景：世界各地的高血压控制很差，特别是在低收入和中等收入国家(LMIC)。有效的应对需要了解从进入或第一次接触卫生系统，到治疗开始和后续行动，在患者通过卫生系统的每个阶段发挥作用的因素。这项系统性综述旨在确定高血压控制的障碍和促进者，以及分别克服或加强它们的方法。方法：检索Medline、EMBASE、Global Health、CINAHL Plus和Africa-wide Information(1980-2019年4月)，检索LMICs中关于高血压成人的研究，报告至少两个充分描述的卫生系统接触者的详细信息。数据由2名评价者提取和分析。使用NVivo开发了与患者相关的主题(社会人口、知识和健康信念、健康状况和共病、权衡)、社会(社会关系和传统)和卫生系统领域(资源和进程)。根据系统回顾和荟萃分析(PRISMA)指南的首选报告项目报告结果。结果：在鉴定的2584条记录中，有30条进入叙事综合。在入选时，“卫生系统资源和流程”和“关于高血压的知识和信念”占主导地位，而“社会关系和传统”和“合并症”随后变得更加重要，患者在随访期间会与家人的优先事项进行“权衡”。社会人口因素起了一定作用，但程度低于其他因素。背景很重要。结论：了解高血压控制过程中不断变化的障碍，对于全面有效地应对这一长期存在的问题是必要的。
Background: Hypertension control is poor everywhere, especially in low- and middle-income countries (LMICs). An effective response requires understanding factors acting at each stage on the patients’ pathway through the health system from entry or first contact with the health system, through to treatment initiation and follow up. This systematic review aimed to identify barriers to and facilitators of hypertension control along this pathway and, respectively, ways to overcome or strengthen them. Methods: MEDLINE, EMBASE, Global Health, CINAHL Plus, and Africa-Wide Information (1980-April 2019) were searched for studies of hypertensive adults in LMICs reporting details of at least 2 adequately described health system contacts. Data were extracted and analysed by 2 reviewers. Themes were developed using NVivo in patient-related (sociodemographic, knowledge and health beliefs, health status and co-morbidities, trade-offs), social (social relationships and traditions) and health system domains (resources and processes). Results are reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: From 2584 identified records, 30 were included in the narrative synthesis. At entry, ‘health systems resources and processes’ and ‘knowledge and beliefs about hypertension’ dominated while ‘social relations and traditions’ and ‘comorbidities’ assume greater importance subsequently, with patients making ‘trade-offs’ with family priorities during follow up. Socio-demographic factors play a role, but to a lesser extent than other factors. Context matters. Conclusion: Understanding the changing barriers to hypertension control along the patient journey is necessary to develop a comprehensive and efficient response to this persisting problem.
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影响因子：
2.3
作者：
Mogensen, Hanne O
通讯作者：
Mogensen, Hanne O
影响因子：
3.7
作者：
Atinga, Roger A.;Yarney, Lily;Gavu, Narissa Minta
通讯作者：
Gavu, Narissa Minta
筛查高血压（坦桑尼亚）的高血压后，医疗保健服务的利用率较低：一项基于人群的前瞻性研究。
影响因子：
4.5
作者：
Bovet P;Gervasoni JP;Mkamba M;Balampama M;Lengeler C;Paccaud F
通讯作者：
Paccaud F
影响因子：
3.3
作者：
Kotwani, Prashant;Balzer, Laura;Charlebois, Edwin D.
通讯作者：
Charlebois, Edwin D.
影响因子：
2.9
作者：
Mekonnen, Habtamu Sewunet;Gebrie, Mignote Hailu;Gelagay, Abebaw Addis
通讯作者：
Gelagay, Abebaw Addis