Supporting self-management for people with hypertension: a meta-review of quantitative and qualitative systematic reviews.

OBJECTIVES: Globally, healthcare policy promotes supported self-management as a strategy for people with long-term conditions. This meta-review aimed to explore how people with hypertension make sense of their condition, to assess the effectiveness of supported self-management in hypertension, and to identify effective components of support. METHODS: From a search of eight databases (January 1993-October 2012; update June 2017) we included systematic syntheses of qualitative studies of patients' experiences, and systematic reviews of randomized controlled trials evaluating the impact of supported self-management on blood pressure and medication adherence. We used meta-ethnography, meta-Forest plots and narrative analysis to synthesise the data. RESULTS: Six qualitative and 29 quantitative reviews provided data from 98 and 446 unique studies, respectively. Self-management support consistently reduced SBP (by between 2 and 6 mmHg), and DBP (by between 1 and 5 mmHg). Information about hypertension and treatment, home BP monitoring (HBPM) and feedback (including telehealth) were widely used in effective interventions. Patients' perceptions of a disease with multiple symptoms contrasted with the professional view of an asymptomatic condition. HBPM, in the context of a supportive patient-professional relationship, changed perceptions of the significance of symptoms and fostered confidence in ability to self-manage hypertension. CONCLUSION: Our systematic qualitative and quantitative meta-reviews tell complementary stories. Supported self-management can improve blood pressure control. Interventions are complex and encompass a broad range of support strategies. HBPM (with or without telehealth) within the context of a supportive patient-professional partnership can bridge the gap between medical and lay perspectives of hypertension and enable effective self-management.

Investment for health and well-being: a review of the social return on investment from public health policies to support implementing the Sustainable Development Goals by building on Health 2020

Governments across the WHO European Region need to take urgent action to address the growing public health, inequality, economic and environmental challenges in order to achieve sustainable development (meeting current needs without compromising the ability of future generations to meet their own needs) and to ensure health and well-being for present and future generations. Based on a scoping review, this report concludes that current investment policies and practices (doing business as usual) are unsustainable, with high costs to individuals, families, communities, societies, the economy and the planet. Investment in public health policies that are based on values and evidence provides effective and efficient, inclusive and innovative solutions that can drive social, economic and environmental sustainability. Investing for health and well-being is a driver and an enabler of sustainable development, and vice versa, and it empowers people to achieve the highest attainable standard of health for all.

Investment for health and well-being: a review of the social return on investment from public health policies to support implementing the Sustainable Development Goals by building on Health 2020

Governments across the WHO European Region need to take urgent action to address the growing public health, inequality, economic and environmental challenges in order to achieve sustainable development (meeting current needs without compromising the ability of future generations to meet their own needs) and to ensure health and well-being for present and future generations. Based on a scoping review, this report concludes that current investment policies and practices (doing business as usual) are unsustainable, with high costs to individuals, families, communities, societies, the economy and the planet. Investment in public health policies that are based on values and evidence provides effective and efficient, inclusive and innovative solutions that can drive social, economic and environmental sustainability. Investing for health and well-being is a driver and an enabler of sustainable development, and vice versa, and it empowers people to achieve the highest attainable standard of health for all. This publication was tabled as a background document during the Sixty-seventh session of the Regional Committee for Europe, Budapest, 11–14 September 2017.

Инвестиции в интересах здоровья и благополучия: анализ общественной эффективности инвенций в стратегии общественного здравоохранения для поддержки выполнения Целей в области устойчивого развития на основе политики Здоровье-2020

Правительствам стран Европейского региона ВОЗ необходимо принять срочные меры для преодоления растущих проблем в области общественного здравоохранения, неравенств, а также экономических и экологических вызовов для того, чтобы добиться устойчивого развития (т.е. удовлетворить нынешние потребности без ущерба для способности будущих поколений удовлетворять свои собственные потребности) и гарантировать здоровье и благополучие нынешнему и будущим поколениям. На основе оценки масштабов осуществляемой деятельности авторы доклада делают вывод о том, что нынешняя инвестиционная политика и практика (“работа в привычном режиме”) является неустойчивой и влечет за собой высокие издержки для отдельных граждан, их семей, сообществ, обществ, национальной экономики и всей планеты. Инвестиции в реализацию мер общественного здравоохранения, которые опираются на ценностные ориентиры и фактические данные, обеспечивают эффективные и рациональные, инклюзивные и инновационные решения, которые могут служить стимулом для обеспечения социальной, экономической и экологической устойчивости. Инвестиции в интересах здоровья и благополучия стимулируют и делают возможным устойчивое развитие (и наоборот), что позволяет обеспечить наивысший достижимый уровень здоровья для всех людей. Эта публикация была представлена для обсуждения в качестве справочного документа на Шестьдесят седьмой сессии Европейского регионального комитета, Будапешт, 11–14 сентября 2017 г.