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. 2015 Nov;28(11):1316-24.
doi: 10.1093/ajh/hpv029. Epub 2015 Mar 23.

Self-Screening and Non-Physician Screening for Hypertension in Communities: A Systematic Review

Susannah Fleming  1 , Helen Atherton  1 , David McCartney  1 , James Hodgkinson  2 , Sheila Greenfield  2 , Frederick David Richard Hobbs  1 , Jonathan Mant  3 , Richard J McManus  1 , Matthew Thompson  4 , Alison Ward  5 , Carl Heneghan  1
Affiliations

Self-Screening and Non-Physician Screening for Hypertension in Communities: A Systematic Review

Susannah Fleming et al. Am J Hypertens. 2015 Nov.

Abstract

Background: Community-based self-screening may provide opportunities to increase detection of hypertension, and identify raised blood pressure (BP) in populations who do not access healthcare. This systematic review aimed to evaluate the effectiveness of non-physician screening and self-screening of BP in community settings.

Methods: We searched the Cochrane Central Trials Register, Medline, Embase, CINAHL, and Science Citation Index & Conference Proceedings Citation Index-Science to November 2013 to identify studies reporting community-based self-screening or non-physician screening for hypertension in adults. Results were stratified by study site, screener, and the cut-off used to define high screening BP.

Results: We included 73 studies, which described screening in 9 settings, with pharmacies (22%) and public areas/retail (15%) most commonly described. We found high levels of heterogeneity in all analyses, despite stratification. The highest proportions of eligible participants screened were achieved by mobile units (range 21%-88%) and pharmacies (range 40%-90%). Self-screeners had similar median rates of high BP detection (25%-35%) to participants in studies using other screeners. Few (16%) studies reported referral to primary care after screening. However, where participants were referred, a median of 44% (range 17%-100%) received a new hypertension diagnosis or antihypertensive medication.

Conclusions: Community-based non-physician or self-screening for raised BP can detect raised BP, which may lead to the identification of new cases of hypertension. However, current evidence is insufficient to recommend specific approaches or settings. Studies with good follow-up of patients to definitive diagnosis are needed.

Keywords: blood pressure; community health services; hypertension; primary care; screening; self-evaluation; self-screening..

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Figures

Figure 1.
Figure 1.
Flow chart.
Figure 2.
Figure 2.
Visualization of quality assessment.
Figure 3.
Figure 3.
Proportion of eligible participants receiving screening, ordered by site.
Figure 4.
Figure 4.
Proportion of screened participants with raised screening blood pressure, ordered by screener.
Figure 5.
Figure 5.
Proportion of screened participants with and without preexisting hypertension diagnoses found to have high screening blood pressure.
See this image and copyright information in PMC

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