Table 1 Description of the study characteristics and findings among the 30 studies
From: Interventions in hypertension: systematic review and meta-analysis of natural and quasi-experiments
First author, year | Type of study (sample size, study design, intervention duration in months, data source) | Population (geographic region, subpopulation) | Level of intervention (settings) | Intervention targeted | Reasons why the study did not use RCTs to evaluate interventions | Findings |
|---|---|---|---|---|---|---|
Studies that reported hypertension prevalence change | ||||||
Barnidge, 2015 [24] | • N = 794 • Design: DID • Duration: 24 months • Data sources: Primary | • Region: America • Subpopulation: all genders and racial/ethnic groups • Participants: General population | Community | Nutrition education and give access to fruits and vegetables through community gardens Type: Education and counseling Domain: Nutrition, social and economic factors | The authors stated that a randomized design would have been hard to be conducted in community-based work. | Treatment group hypertension prevalence in the beginning: 61.0% Treatment group hypertension prevalence in the middle: 45.0%; P-value beginning vs. middle < 0.01 Treatment group hypertension OR beginning vs. middle: 0.52; 95% CI: (0.38; 0.71) Control group hypertension prevalence in the beginning: 46.7% Control group hypertension prevalence in the middle: 49.8%; P-value beginning vs. middle = 0.39 Control group hypertension OR in the beginning vs. middle: 1.11; 95% CI: (0.81; 1.54) |
Sahli, 2016 [25] | • N = 2000 • Design: PPCG • Duration: 36 months • Data Source: Primary | • Region: Africa • Subpopulation: all genders and racial/ethnic groups • Participants: General population | Community | Healthy lifestyle promotion, education on smoking, physical activity, and diet. Free smoking cessation consultations. Type: Education and counseling Domain: Lifestyle | The authors did not justify why an RCT was not undertaken to evaluate the effectiveness of the intervention. | All participants: Treatment group hypertension prevalence in the beginning: 37.3% Treatment group hypertension prevalence at the end: 33.7%; P-value beginning vs. end: 0.1 Control group hypertension prevalence in the beginning: 31.1% Control group hypertension prevalence at the end: 33.4%; P-value beginning vs. end: 0.28 Among participants younger than 40 years old: Treatment group hypertension prevalence in the beginning: 22.8% Treatment group hypertension prevalence at the end: 16.2%; P-value beginning vs. end: 0.01 Control group hypertension prevalence in the beginning: 14.0% Control group hypertension prevalence at the end: 15.1%; P-value beginning vs. end: 0.52 Among nonobese participants: Treatment group hypertension prevalence in the beginning: 31.4% Treatment group hypertension prevalence at the end: 26.2%; P-value beginning vs. end: 0.03 Control group hypertension prevalence in the beginning: 21.9% Control group hypertension prevalence at the end: 25.1%; P-value beginning vs. end: 0.17 |
Comin, 2017 [18] | • N = 189,067 • Design: PPCG • Duration: 30 months • Data Source: Primary | • Region: Europe • Subpopulation: all genders and racial/ethnic groups, aged 35–74 years • Participants: Patients with hypertension and diabetes and hypercholesterolemia | Health center | Computerized clinical practice guidelines: General practitioners had General practitioners accessed the computerized clinical practice guidelines at least twice a day Type: Management Domain: Care | The authors did not justify why an RCT was not undertaken to evaluate the effectiveness of the intervention. | In hypertension patients: Women: Treatment group percentage of improved BP control: 9.8% Control group percentage of improved BP control: 6.7% Treatment group vs. Control group percentage of improved BP control: P-value < 0.001 Men: Treatment group percentage of improved BP control: 11.8% Control group percentage of improved BP control: 7.9% Treatment group vs. Control group_ percentage of improved BP control: P-value < 0.001 |
Fikri-Benbrahim, 2012 [26] | • N = 177 • Design: PPCG • Duration: 5 months • Data Source: Primary | • Region: Europe • Subpopulation: all genders and racial/ethnic groups • Participants: all hypertension patients | Community | Pharmacist intervention comprising (1) education about hypertension, (2) home blood pressure monitoring, and (3) referral to a physician through personalized reports when necessary Type: Education, counseling and management Domain: Lifestyle, pharmacological therapy | The authors did not justify why an RCT was not undertaken to evaluate the effectiveness of the intervention. | Treatment group percentage of controlled BP in the beginning: 71.3% Treatment group percentage of controlled BP at the end: 52.9% Treatment group percentage of controlled BP change P-value: 0.01 Control group percentage of controlled BP in the beginning: 55.1% Control group percentage of controlled BP at the end: 50.6% Control group percentage of controlled BP change P-value: 0.48 Treatment group vs. Control group percentage of controlled BP P-value: 0.026 Achieving BP control treatment group vs. control group OR: 2.46; 95% CI: (1.15, 5.24); P-value: 0.02 |
James, 2018 [17] | • N = 53,738 (12,555 with cardiovascular disease, and 41,183 with hypertension) • Design: DID • Duration: 6 months • Data Source: Primary | • Region: America • Subpopulation: all genders and racial/ethnic groups • Participants: Patients with cardiovascular disease and hypertension | Health center | Population Health Management Intervention: Adding a dedicated population health coordinator who identifies and reaches out to patients not meeting cardiovascular care goals to health management programs Type: Screening and referral for management Domain: Care | The authors did not justify why an RCT was not undertaken to evaluate the effectiveness of the intervention. | Non-Hispanic White: BP control PHC vs. non-PHC: OR = 1.13, 95% CI: (1.05, 1.22) Non-Hispanic Black: BP control PHC vs. non-PHC: OR = 1.17; 95% CI: (0.94, 1.45) Hispanic: BP control PHC vs. non-PHC: OR = 0.90; 95% CI: (0.59, 1.36) Non-Hispanic Black vs. Non-Hispanic White patients: OR = 1.05; 95% CI: (0.83, 1.31) Hispanic vs. non-Hispanic White patients: OR = 0.82; 95% CI: (0.53, 1.25) |
Studies that reported mean blood pressure change | ||||||
Intervention subgroup: education and counseling | ||||||
Flannery, 2012 [27] | • N = 39 • Design: DID • Duration: 6 months • Data Source: Primary | • Region: America • Subpopulation: Only women of all racial/ethnic groups • Participants: nurse assistant | Organization | The Worksite Heart Health Improvement: Environmental and policy assessment; education; and ongoing motivation Type: Education and counseling Domain: Diet, physical activity, environmental and policy factors | The authors did not justify why an RCT was not undertaken to evaluate the effectiveness of the intervention. | Treatment group mean SBP in the beginning: 129.28; SD: 17.9 Treatment group mean SBP at the end: 119.88; SD: 14.76 Control group mean SBP in the beginning: 125.26; SD: 18.74 Control group mean SBP at the end: 120.3; SD: 14.43 Treatment group mean DBP in the beginning: 77.5; SD: 8.98 Treatment group mean DBP at the end: 70.84; SD: 6.82 Control group mean DBP in the beginning: 74.4; SD: 13.52 Control group mean DBP at the end: 74.43; SD: 11.77 |
Gemson, 2008 [28] | • N = 141 • Design: PPCG • Duration: 12 months • Data Source: Primary | • Region: America • Subpopulation: all genders and racial/ethnic groups • Participants: all hypertension patients | Organization | Multicomponent workplace intervention comprising informational health messages, use of a pedometer bioelectrical impedance measured body weight and physical activity education Type: Education and counseling Domain: Lifestyle, physical activity, body fat measurement | The authors did not justify why an RCT was not undertaken to evaluate the effectiveness of the intervention. | Treatment group SBP MD: −10.6; SD: 111.4 Treatment group DBP MD: −6.1; SD: 8.9 Control group SBP MD: −2.1; SD: 9.3 Control group DBP MD: 0.1; SD: 6.2 |
Lin, 2017 [29] | • N = 99 • Design: PPCG • Duration: 3 months • Data Source: Primary | • Region: Asia • Subpopulation: all genders and racial/ethnic groups, aged 20 years and older • Participants: office workers | Organization | Implementation of a “Sit Less, Walk More” Workplace intervention comprising five components: Monthly newsletters, motivational tools, pedometer challenge, environmental prompts and walking route Type: Education and counseling Domain: Lifestyle, physical activity | The authors did not justify why an RCT was not undertaken to evaluate the effectiveness of the intervention. | Treatment group SBP MD: −1.1; SD: 11.7 Treatment group DBP MD: −2.6; SD: 8.9 Control group SBP MD: 1; SD: 16.3 Control group DBP MD: 2.6; SD: 11.7 |
Chang, 2013 [30] | • N = 133 • Design: PPCG • Duration: 3 months • Data Source: Primary | • Region: Asia • Subpopulation: all genders and racial/ethnic groups, aged 55 years and older • Participants: General population | Community | 60-min Tai Chi physical activity practice Type: Education and counseling Domain: Physical activity | The authors did not justify why an RCT was not undertaken to evaluate the effectiveness of the intervention. | Treatment group vs. Control group SBP: − 14.3; 95% CI: (− 19.2, − 9.4) Treatment group vs. Control group DBP: − 7.02; 95% CI: (− 10.6, − 3.4) |
Verberne, 2016 [31] | • N = 381 • Design: PPCG • Duration: 12 months • Data Source: Primary and secondary | • Region: Europe • Subpopulation: all genders and racial/ethnic groups • Participants: overweight and obese patients | Health center | Prescription of lifestyle modifications by general practitioners which consisted of advice and referrals pertaining to diet and physical activity Type: Education and counseling Domain: Lifestyle, physical activity, nutrition | The authors did not justify why an RCT was not undertaken to evaluate the effectiveness of the intervention. | Treatment group SBP MD: − 3.5; SD: 15.4 Treatment group DBP MD: − 3.4; SD: 9 Control group SBP MD: − 3; SD: 15.5 Control group DBP MD: − 3.6; SD: 8.5 |
Xu, 2015 [32] | • N = 38 • Design: PPCG • Duration: 4 months • Data Source: Primary | • Region: America • Subpopulation: women of all racial/ethnic groups aged 60 years or older • Participants: obese patients | Community | Tai Chi physical activity and nutrition education and a behavioral weight loss program based on a modified DASH diet Type: Education and counseling Domain: Lifestyle, physical activity, nutrition | The authors stated that although the study of the intervention has been done as an RCT in a clinic, they wanted to translate the intervention in a community setting. | Treatment group vs. Control group SBP: − 8.9; 95% CI: (− 19.1, 1.4) Treatment group vs. Control group DBP: − 3.4; 95% CI: (− 9.8, 3.09) |
Zhu, 2018 [33] | • N = 36 • Design: PPCG • Duration: 4 months • Data Source: Primary | • Region: America • Subpopulation: all genders and racial/ethnic groups aged 18–25 years old • Participants: office workers | Organization | A workplace physical activity intervention comprising sit-stand workstations and sitting-specific motivational support and instructions Type: Education and counseling Domain: Physical activity | The authors stated that a randomized design would have been hard to be conducted in real world organizational settings. | Treatment group mean SBP in the beginning: 119.1; SD: 16.4 Treatment group mean SBP at the end: 121.4; SD: 19.8 Control group mean SBP in the beginning: 118.8; SD: 12.2 Control group mean SBP at the end: 123.8; SD: 10.6 Treatment group mean DBP in the beginning: 75.6; SD: 10.3 Treatment group mean DBP at the end: 77.2; SD: 12.2 Control group mean DBP in the beginning: 77.2; SD: 10.8 Control group mean DBP at the end: 78.9; SD: 6.9 |
Kamran, 2016 [34] | • N = 138 • Design: PPCG • Duration: 6 months • Data source: Primary | • Region: Asia • Subpopulation: all genders and racial/ethnic groups • Participants: Patients with hypertension | Health center | Nutritional advice/education about the DASH approach which was presented in group teaching sessions Type: Education and counseling Domain: Diet | The authors did not justify why an RCT was not undertaken to evaluate the effectiveness of the intervention. | Treatment group SBP MD: − 13.0; SD: 10.2 Treatment group DBP MD: − 7.3; SD: 5.3 Control group SBP MD: 0.5; SD: 12.2 Control group DBP MD: − 0.7; SD: 7.8 |
Ibrahim, 2016 [35] | • N = 268 • Design: PPCG • Duration: 12 months • Data source: Primary | • Region: Asia • Subpopulation: all genders and racial/ethnic groups aged between 18 and 65 years old • Participants: Patients with prediabetes | Community | Group-based sessions and individual counseling to reinforce behavioral change (diet, physical activity) Type: Education and counseling Domain: Lifestyle | The authors stated that a randomized design would have been hard to be conducted in community-based work. | Treatment group vs. Control group SBP: − 1.71; 95% CI: (− 3.97, 0.56) Treatment group vs. Control group DBP: − 2.63; 95% CI: (− 3.79, − 1.48) |
Kassim, 2017 [36] | • N = 328 • Design: PPCG • Duration: 6 months • Data source: Primary | • Region: Asia • Subpopulation: low socio-economic status housewives aged 18–59 years old, all ethnic groups • Participants: Overweight and obese housewives | Community | Lifestyle interventions consisting of a healthy diet, physical activity, and self-monitoring behaviors Type: Education and counseling Domain: Lifestyle | The authors stated that a randomized design would have been hard to be conducted in community-based work. | Treatment group mean SBP in the beginning: 122.29; SD: 16.84 Treatment group mean SBP at the end: 116.45; SD: 14.62 Control group mean SBP in the beginning: 120.63; SD: 14.62 Control group mean SBP at the end: 114.59; SD: 14.86 Treatment group mean DBP in the beginning: 78.59; SD: 12.03 Treatment group mean DBP at the end: 77.14; SD: 11.15 Control group mean DBP in the beginning: 77.83; SD: 9.54 Control group mean DBP at the end: 76.10; SD: 9.49 |
Fazliana, 2018 [37] | • N = 328 • Design: PPCG • Duration: 12 months • Data Source: Primary | • Region: Asia • Subpopulation: housewives aged 18–59 years old • Participants: Overweight and obese housewives | Community | The weight loss intervention, consisted of individual diet counseling, group exercise and self-monitoring tools Type: Education and counseling Domain: Lifestyle | The authors did not justify why an RCT was not undertaken to evaluate the effectiveness of the intervention. | Treatment group SBP MD in the 6 months: − 6.81; 95% CI: (− 9.72, − 3.90) Treatment group DBP MD in the 6 months: − 1.71; 95% CI: (− 3.71, 0.28) Control group SBP MD in the 6 months: − 7.95; 95% CI: (− 11.69, − 4.20) Control group DBP MD in the 6 months: − 1.73; 95% CI: (− 4.12, 0.67) |
Sahli, 2016 [25] | • N = 2000 • Design: PPCG • Duration: 36 months • Data Source: Primary | • Region: Africa • Subpopulation: all genders and racial/ethnic groups • Participants: General population | Community | Healthy lifestyle promotion, education on smoking, physical activity, and diet. Type: Education and counseling Domain: Lifestyle | The authors did not justify why an RCT was not undertaken to evaluate the effectiveness of the intervention. | Treatment group mean SBP in the beginning: 132.4; SD: 19.2 Treatment group mean SBP at the end: 130.6; SD: 17.7 Control group mean SBP in the beginning: 129.7; SD: 17.8 Control group mean SBP at the end: 130.4; SD: 17.9 Treatment group mean DBP in the beginning: 78.7; SD: 11.7 Treatment group mean DBP at the end: 76.9; SD: 11.1 Control group mean DBP in the beginning: 78.1; SD: 10.8 Control group mean DBP at the end: 76.7; SD: 11.0 |
Intervention subgroup: management | ||||||
Panattoni, 2017 [19] | • N = 11,190 (hypertension patients aged 18–59 years: N = 4385; hypertension patients aged 60–80 years: N = 4620;diabetes patients aged 18–75 years: N = 3768) • Design: DID • Duration:12 months • Data Source: Secondary | • Region: America • Subpopulation: all genders and racial/ethnic groups • Participants: Patients with hypertension or diabetes | Health center | Team based chronic care model, redesigned primary care visits to enhance the self-management support provided by physicians, and a health coaching program. Type: Management Domain: Care | The authors did not justify why an RCT was not undertaken to evaluate the effectiveness of the intervention. | Adjusted results: Among diabetes patients aged 18–75 years over the 6-month period: Treatment group vs. Control group SBP: − 1.65; 95% CI: (− 3.68, 0.39) Treatment group vs. Control group DBP: − 1.13; 95% CI: (− 2.23, − 0.04) Among hypertension patients aged 18–59 years over the first 6-month period: Treatment group vs. Control group SBP: − 0.75; 95% CI: (− 2.82, 1.31) Treatment group vs. Control group DBP: − 0.58; 95% CI: (− 1.87, 0.71) Among hypertension patients aged 60–80 years over the 6-month period: Treatment group vs. Control group SBP: − 0.96; 95% CI: (− 2.86, 0.95) Treatment group vs. Control group DBP: − 1.03; 95% CI: (− 2.07, 0.01) Unadjusted results of diabetes aged 18–75 years: Treatment group mean SBP in the beginning: 126.5; SD: 12.7 Treatment group mean SBP at the end: 125.5; SD: 15.3 Control group mean SBP in the beginning: 129.8; SD: 13.2 Control group mean SBP at the end: 129.8; SD: 15.7 Treatment group mean DBP in the beginning: 76.4; SD: 7.7 Treatment group mean DBP at the end: 74.4; SD: 8.8 Control group mean DBP in the beginning: 76.2; SD: 7.9 Control group mean DBP at the end: 74.9; SD: 9.4 |
Miao, 2018 [38] | • N = 1673 pairs • Design: PSM & DID • Duration: 12 months • Data Source: Primary | • Region: Asia • Subpopulation: all genders and racial/ethnic groups • Participants: Patients with hypertension | Community | Improve the performance of social health insurance system through increasing outpatient expenditure reimbursement ratio. Type: Management Domain: Payment | The authors did not justify why an RCT was not undertaken to evaluate the effectiveness of the intervention. | SBP MD: −2.9, P-value = 0.011 DBP MD: − 7.9,P-value = 0.508 |
Scanlon, 2008 [39] | • N = 2067 • Design: DID & PSM • Duration: 12 months • Data source: Secondary | • Region: America • Subpopulation: all genders and racial/ethnic groups • Participants: Patients with diabetes | Health center | Team-Based Treatment: Collaborative team-based treatment with teams comprising a physician or nurse practitioner, care manager, medical assistant, information specialist, and a part-time social worker Type: Management Domain: Care | The authors did not justify why an RCT was not undertaken to evaluate the effectiveness of the intervention. | All CareSouth patients: SBP MD per year: − 0.88;P-value: 0.01 CareSouth patients with baseline SBP > 140: SBP MD per year: − 2.2;P-value: 0.04); 95% CI: (− 3.88, − 0.44) |
Intervention subgroup: education, counseling and management | ||||||
Darviri, 2016 [40] | • N = 548 • Design: DID • Duration: 2 months • Data Source: Primary | • Region: Europe • Subpopulation: all genders and racial/ethnic groups, aged 18–65 years, residents of Athens and literate in Greek • Participants: all hypertension and pre-hypertension patients | Nation | Stress management: Biofeedback-assisted diaphragmatic breathing and relaxation, lifestyle counseling, cognitive reconstruction and other relaxation techniques Type: Education, counseling and management Domain: Stress | The authors did not justify why an RCT was not undertaken to evaluate the effectiveness of the intervention. | SBP MD: − 2.62; 95% CI: (− 3.96, − 1.29) DBP MD: − 1; 95% CI: (− 1.9, − 0.93) |
Fernandez, 2008 [41] | • N = 65 • Design: PPCG • Duration: 4 months • Data Source: Primary | • Region: America • Subpopulation: all genders and Black, African American, Latino or Hispanic racial/ethnic groups, aged 60 and older • Participants: all hypertension patients | Community | Lifestyle modification education about hypertension, antihypertensive medications, diet and physical activity, and adherence to medication Type: Education, counseling and management Domain: Pharmacological therapy, diet and physical activity | The authors did not justify why an RCT was not undertaken to evaluate the effectiveness of the intervention. | Treatment group SBP MD: − 13; SD: 18.5 Treatment group DBP MD: − 5.6; SD: 10.8 Control group SBP MD: − 10.6; SD: 24 Control group DBP MD: − 3; SD: 11.8 |
Fikri-Benbrahim, 2012 [26] | • N = 177 • Design: PPCG • Duration: 5 months • Data Source: Primary | • Region: Europe • Subpopulation: all genders and racial/ethnic groups • Participants: all hypertension patients | Community | Pharmacist intervention comprising (1) education about hypertension, (2) home blood pressure monitoring, and (3) referral to a physician through personalized reports when necessary Type: Education, counseling and management Domain: Lifestyle. Pharmacological therapy | The authors did not justify why an RCT was not undertaken to evaluate the effectiveness of the intervention. | Treatment group SBP MD: − 6.8; SD: 13.7 Treatment group DBP MD: − 2.1; SD: 8.9 Control group SBP MD: − 2.1; SD: 9.3 Control group DBP MD: 0.1; SD: 6.2 |
Jung, 2017 [42] | • N = 64 • Design: PPCG • Duration: 7 months • Data Source: Primary | • Region: Asia • Subpopulation: all genders and racial/ethnic groups, aged 65 years or older • Participants: all hypertension patients | Community | In-class educational on hypertension management, community-based eHealth monitoring, and monthly telephone counseling Type: Education, counseling and management Domain: Lifestyle | The authors stated that a randomized design would have been hard to be conducted in community-based work. | Treatment group SBP MD: − 11.4; SD: 12.5 Treatment group DBP MD: − 3; SD: 8.5 Control group SBP MD: − 0.6; SD: 11.7 Control group DBP MD: 0.6; SD: 9.5 |
Hussain, 2016 [43] | • N = 629 • Design: DID & PSM • Duration: 3 months • Data sources:Primary and secondary | • Region: America • Subpopulation: all genders and racial/ethnic groups, aged 40–74 years • Participants: all hypertension patients | Health center | Nutritional and pharmacological therapy and lifestyle counseling, and medication adherence Type: Education, counseling and management Domain: Lifestyle, pharmacological therapy | The authors stated that a randomized design would have been hard to be conducted in a pragmatic clinical setting. | SBP MD: 9;P-value < 0.001 DBP MD: 4; P-value: 0.004 |
Miao, 2016 [44] | • N = 1426 • Design: DID • Duration: 24 months • Data Source: Primary | • Region: Asia • Subpopulation: all genders and racial/ethnic groups • Participants: Patients with hypertension | Health center | Integration of preventive-curative services delivery and cooperation among village-town-county physicians, including educating on smoking cessation, moderate drinking, light and healthy diet, regular exercise and to take blood pressure drugs regularly, monitor the blood pressure Type: Education, counseling and management Domain: Lifestyle, pharmacological therapy | The authors did not justify why an RCT was not undertaken to evaluate the effectiveness of the intervention. | SBP MD: − 5.62; SD: 16.49 DBP MD: − 5.43; SD: 15.03 |
Visanuyothin, 2018 [45] | • N = 128 • Design: PPCG • Duration: 5 months • Data source: Primary | • Region: Asia • Subpopulation: all genders and racial/ethnic groups • Participants: Patients with hypertension | Health center | Integrated program with home blood pressure monitoring and village health volunteers. Group-based health education on home blood pressure monitoring and self-monitoring during workshops, including hypertension measurement skills, self-management Type: Education, counseling and management Domain: Care | The authors stated that a randomized design would have been hard to be conducted in a pragmatic clinical setting. | Treatment group mean SBP in the beginning: 134.72; SD: 13.38 Treatment group mean SBP at the end: 130.21; SD: 11.88 Control group mean SBP in the beginning: 129.27; SD: 14.01 Control group mean SBP at the end: 131.89; SD: 12.31 Treatment group mean DBP in the beginning: 80.66; SD: 8.22 Treatment group mean DBP at the end: 77.59; SD: 7.94 Control group mean DBP in the beginning: 75.70; SD: 7.50 Control group mean DBP at the end: 77.29; SD: 6.82 |
Intervention subgroup: screening and referral for management | ||||||
Berkowitz, 2017 [16] | • N = 5125 • Design: DID • Duration: 31 months • Data source: Primary | • Region: America • Subpopulation: all genders and racial/ethnic groups • Participants: All patients. | Health center | Addressing unmet basic resource needs: Screening for unmet needs at clinic visits, and offering those who screen positive to meet with an advocate to help obtain resources, or receive brief information provision Type: Screening and referral for management Domain: Social and economic risk factors | The authors stated that a randomized design would have been hard to be conducted in a pragmatic clinical setting. The findings are more generalizable to other primary care settings than using RCTs. | SBP MD: − 2.6; 95% CI: (−3.5, − 1.7) DBP MD: − 1.4; 95% CI: (− 1.9, − 0.9) |
Scharf, 2016 [46] | • N = 791 • Design: DID • Duration: 24 months • Data Source: Primary | • Region: America • Subpopulation: all genders and racial/ethnic groups aged 18 years and older • Participants: patients with serious mental illness | Health center | Primary and Behavioral Health Care Integration program: Screening and referral for general medical illness prevention and treatment, registry and tracking systems for general medical needs and outcomes, care management, and prevention and wellness services Type: Screening and referral for management Domain: Care | The authors did not justify why an RCT was not undertaken to evaluate the effectiveness of the intervention. | Treatment group SBP MD: − 14; SE: 1 Treatment group DBP MD: − 13; SE: 1 Control group SBP MD: − 13; SE: 2 Control group DBP MD: − 10; SE: 1 |
Chang, 2016 [47] | • N = 138,788 • Design: DID • Duration: 24 months • Data Source: Primary and secondary | • Region: Europe • Subpopulation: all genders and racial/ethnic groups, aged 40–74 years • Participants: All patients | Nation | Participated in The National (England) Health Service Check—a Cardiovascular risk assessment and management program: screening, tailored management strategies including lifestyle advice Type: Screening and referral for management Domain: CVD risk factors | The authors did not justify why an RCT was not undertaken to evaluate the effectiveness of the intervention. | SBP MD: − 2.51; 95% CI: (− 2.77, − 2.25) DBP MD: − 1.46; 95% CI: (− 1.62, − 1.29) |
Yu, 2017 [48] | • N = 10,262 • Design: PSM • Duration: 12 months • Data Source: Primary | • Region: Asia • Subpopulation: all genders and racial/ethnic groups, aged less than 80 years • Participants: all hypertension patients | Health center | Risk assessment and management program for patients with hypertension in public primary care clinics: Standardized CVD-risk assessment, hypertensive complication screening as well as adherence to medications and lifestyles Type: Screening and referral for management Domain: Lifestyle | The authors stated that a randomized design would have been hard to be conducted in a pragmatic clinical setting. | Treatment group mean SBP in the beginning: 148.7; SD: 8.18 Treatment group mean SBP at the end: 136.85; SD: 9.64 Control group mean SBP in the beginning: 148.68; SD: 8.34 Control group mean SBP at the end: 137.68; SD: 10.48 Treatment group mean DBP in the beginning: 81.7; SD: 9.34 Treatment group mean DBP at the end: 77.58; SD: 8.37 Control group mean DBP in the beginning: 81.74; SD: 9.09 Control group mean DBP at the end: 77.6; SD: 8.56 |
van de Vijver, 2016 [49] | • N = 2764 • Design: DID • Duration: 18 months • Data Source: Primary | • Region: Africa • Subpopulation: all genders and racial/ethnic groups • Participants: Patients with hypertension | Community | Awareness campaigns, household visits for screening, referral and treatment, promoting long-term retention in care: Type: Screening and referral for management Domain: Care | The authors did not justify why an RCT was not undertaken to evaluate the effectiveness of the intervention. | SBP MD: − 0.32; 95% CI: (− 2.48, 1.83) DBP MD: 1.09; 95% CI: (− 0.29, 2.46) |