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abstract: 'Background: Hypertension control is poor everywhere, especially in
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low-and middle-income countries (LMICs). An effective response requires
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understanding factors acting at each stage on the patients'' pathway
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through the health system from entry or first contact with the health
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system, through to treatment initiation and follow up. This systematic
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review aimed to identify barriers to and facilitators of hypertension
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control along this pathway and, respectively, ways to overcome or
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strengthen them. Methods: MEDLINE, EMBASE, Global Health, CINAHL Plus,
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and Africa-Wide Information (1980-April 2019) were searched for studies
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of hypertensive adults in LMICs reporting details of at least 2
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adequately described health system contacts. Data were extracted and
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analysed by 2 reviewers. Themes were developed using NVivo in
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patient-related (sociodemographic, knowledge and health beliefs, health
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status and co-morbidities, trade-offs), social (social relationships and
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traditions) and health system domains (resources and processes). Results
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are reported according to the Preferred Reporting Items for Systematic
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Reviews and Meta-Analyses (PRISMA) guidelines. Results: From 2584
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identified records, 30 were included in the narrative synthesis. At
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entry, `health systems resources and processes'' and `knowledge and
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beliefs about hypertension'' dominated while `social relations and
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traditions'' and `comorbidities'' assume greater importance subsequently,
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with patients making `trade-offs'' with family priorities during follow
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up. Socio-demographic factors play a role, but to a lesser extent than
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other factors. Context matters. Conclusion: Understanding the changing
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barriers to hypertension control along the patient journey is necessary
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to develop a comprehensive and efficient response to this persisting
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problem. PROSPERO Registration: CRD42017074786 Copyright: (c) 2020 The
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Author(s); Published by Kerman University of Medical Sciences. This is
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an open-access article distributed under the terms of the Creative
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Commons Attribution License
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(http://creativecommons.org/licenses/by/4.0), which permits unrestricted
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use, distribution, and reproduction in any medium, provided the original
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work is properly cited. Citation: Brathwaite R, Hutchinson E, McKee M
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Palafox B, Balabanova D. The long and winding road: a systematic
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literature review conceptualising pathways for hypertension care and
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control in low-and middle-income countries. Int J Health Policy Manag.
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2020;x(x):x-x. doi:10.34172/ijhpm.2020.105'
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affiliation: 'Balabanova, D (Corresponding Author), London Sch Hyg \& Trop Med, Fac
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Publ Hlth \& Policy, Dept Global Hlth \& Dev, London, England.
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Brathwaite, Rachel, Washington Univ, Brown Sch, St Louis, MO 63110 USA.
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Hutchinson, Eleanor; Balabanova, Dina, London Sch Hyg \& Trop Med, Fac Publ Hlth
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\& Policy, Dept Global Hlth \& Dev, London, England.
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McKee, Martin; Palafox, Benjamin, London Sch Hyg \& Trop Med, Fac Publ Hlth \& Policy,
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Dept Hlth Serv Res \& Policy, London, England.'
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author: Brathwaite, Rachel and Hutchinson, Eleanor and McKee, Martin and Palafox,
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Benjamin and Balabanova, Dina
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author-email: dina.balabanova@lshtm.ac.uk
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author_list:
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- family: Brathwaite
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given: Rachel
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- family: Hutchinson
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given: Eleanor
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- family: McKee
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given: Martin
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- family: Palafox
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given: Benjamin
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- family: Balabanova
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given: Dina
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da: '2023-09-28'
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doi: 10.34172/ijhpm.2020.105
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earlyaccessdate: JUL 2020
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eissn: 2322-5939
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files: []
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journal: INTERNATIONAL JOURNAL OF HEALTH POLICY AND MANAGEMENT
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keywords: 'Systematic Review; Hypertension Control; Healthcare Delivery; Health
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Systems; Pathways to Care'
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keywords-plus: 'HEALTH-CARE; QUALITATIVE-ANALYSIS; BARRIERS; DISCONTINUATION;
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MANAGEMENT; ADHERENCE; LINKAGE; PROGRAM; COHORT'
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language: English
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month: MAR
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number: '3'
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number-of-cited-references: '55'
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orcid-numbers: 'McKee, Marc D/0000-0001-8349-965X
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McKee, Martin/0000-0002-0121-9683
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Brathwaite, Rachel/0000-0002-9363-3581
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Balabanova, Dina/0000-0001-7163-3428
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Hutchinson, Eleanor/0000-0002-9718-2407'
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pages: 257-268
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papis_id: 402d7df981031dbb3921d213e22dc144
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ref: Brathwaite2022longwinding
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researcherid-numbers: 'McKee, Marc D/E-2187-2011
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McKee, Martin/E-6673-2018
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'
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tags:
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- review
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times-cited: '8'
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title: 'The Long and Winding Road: A Systematic Literature Review Conceptualising
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Pathways for Hypertension Care and Control in Low- and Middle-Income Countries'
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type: Review
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unique-id: WOS:000719958500001
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usage-count-last-180-days: '0'
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usage-count-since-2013: '2'
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volume: '11'
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web-of-science-categories: Health Care Sciences \& Services; Health Policy \& Services
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year: '2022'
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