abstract: '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. PROSPERO Registration: CRD42017074786 Copyright: (c) 2020 The

  Author(s); Published by Kerman University of Medical Sciences. This is

  an open-access article distributed under the terms of the Creative

  Commons Attribution License

  (http://creativecommons.org/licenses/by/4.0), which permits unrestricted

  use, distribution, and reproduction in any medium, provided the original

  work is properly cited. Citation: Brathwaite R, Hutchinson E, McKee M

  Palafox B, Balabanova D. The long and winding road: a systematic

  literature review conceptualising pathways for hypertension care and

  control in low-and middle-income countries. Int J Health Policy Manag.

  2020;x(x):x-x. doi:10.34172/ijhpm.2020.105'
affiliation: 'Balabanova, D (Corresponding Author), London Sch Hyg \& Trop Med, Fac
  Publ Hlth \& Policy, Dept Global Hlth \& Dev, London, England.

  Brathwaite, Rachel, Washington Univ, Brown Sch, St Louis, MO 63110 USA.

  Hutchinson, Eleanor; Balabanova, Dina, London Sch Hyg \& Trop Med, Fac Publ Hlth
  \& Policy, Dept Global Hlth \& Dev, London, England.

  McKee, Martin; Palafox, Benjamin, London Sch Hyg \& Trop Med, Fac Publ Hlth \& Policy,
  Dept Hlth Serv Res \& Policy, London, England.'
author: Brathwaite, Rachel and Hutchinson, Eleanor and McKee, Martin and Palafox,
  Benjamin and Balabanova, Dina
author-email: dina.balabanova@lshtm.ac.uk
author_list:
- family: Brathwaite
  given: Rachel
- family: Hutchinson
  given: Eleanor
- family: McKee
  given: Martin
- family: Palafox
  given: Benjamin
- family: Balabanova
  given: Dina
da: '2023-09-28'
doi: 10.34172/ijhpm.2020.105
earlyaccessdate: JUL 2020
eissn: 2322-5939
files: []
journal: INTERNATIONAL JOURNAL OF HEALTH POLICY AND MANAGEMENT
keywords: 'Systematic Review; Hypertension Control; Healthcare Delivery; Health

  Systems; Pathways to Care'
keywords-plus: 'HEALTH-CARE; QUALITATIVE-ANALYSIS; BARRIERS; DISCONTINUATION;

  MANAGEMENT; ADHERENCE; LINKAGE; PROGRAM; COHORT'
language: English
month: MAR
number: '3'
number-of-cited-references: '55'
orcid-numbers: 'McKee, Marc D/0000-0001-8349-965X

  McKee, Martin/0000-0002-0121-9683

  Brathwaite, Rachel/0000-0002-9363-3581

  Balabanova, Dina/0000-0001-7163-3428

  Hutchinson, Eleanor/0000-0002-9718-2407'
pages: 257-268
papis_id: 402d7df981031dbb3921d213e22dc144
ref: Brathwaite2022longwinding
researcherid-numbers: 'McKee, Marc D/E-2187-2011

  McKee, Martin/E-6673-2018

  '
tags:
- review
times-cited: '8'
title: 'The Long and Winding Road: A Systematic Literature Review Conceptualising
  Pathways for Hypertension Care and Control in Low- and Middle-Income Countries'
type: article
unique-id: WOS:000719958500001
usage-count-last-180-days: '0'
usage-count-since-2013: '2'
volume: '11'
web-of-science-categories: Health Care Sciences \& Services; Health Policy \& Services
year: '2022'