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Aim: To assess the effects of self‐management interventions on systolic blood pressure, diastolic blood pressure, self‐efficacy, medication adherence and body mass index in older adults with hypertension. Background: Effective treatment of hypertension may require the practice of self‐management behaviours. However, evidence on effects of self‐management interventions on blood pressure, self‐efficacy, medication adherence and body mass index in older adults with hypertension is lacking. Design A systematic review and meta‐analysis. Data sources: CINAHL, Cochrane Library, Embase, Ovid‐Medline, PubMed, Scopus, Web of Science and other sources were searched to October 2020. Review methods: Data were analysed using Comprehensive Meta‐Analysis 2.0 and quality assessment was done using ROB 2.0. The pooled effect sizes were reported as Hedges' g values with corresponding 95% confidence intervals using a random‐effects model. Results: Twelve randomized controlled trials met our inclusion criteria. The results revealed that self‐management interventions significantly decreased blood pressure and increased self‐efficacy and medication adherence in older adult patients with hypertension, with no significant effect on body mass index. Conclusions: Self‐management interventions have considerable beneficial effects in older adults with hypertension. Health care providers should implement self‐management interventions to strengthen the patient's role in managing their health. SUMMARY STATEMENT: What is already known about this topic? Current evidence suggests self‐management interventions as a potential strategy for decreasing blood pressure in patients with hypertension.There is limited evidence of the effectiveness of self‐management interventions on blood pressure, self‐efficacy, medication adherence and body mass index in older adults with hypertension. What this paper adds? Self‐management interventions can decrease systolic blood pressure, diastolic blood pressure and improve self‐efficacy and medication adherence in older adults with hypertension. The implication of this paper: Findings highlight the importance of implementing self‐management programs in older adult patients with hypertension.Health care providers should implement self‐management interventions that are tailored to the individual's level of self‐efficacy to strengthen the patient's role in managing their health care. [ABSTRACT FROM AUTHOR]

Purpose: To examine the effects of health coaching on self‐management and quality of life (QOL) in patients with chronic kidney disease (CKD) and to evaluate whether self‐efficacy and patient activation mediate the effect of health coaching on self‐management and QOL. Design and Methods: A single‐center, parallel‐group, randomized controlled trial. A total of 108 patients with stages 1 to 3a CKD participated in the study. Participants were randomly assigned to a health‐coaching intervention group or a usual care control group. Participants' QOL (World Health Organization Quality of Life Scale), self‐management (CKD Self‐Management instrument), patient activation (Patient Activation Measure), and self‐efficacy (CKD Self‐Efficacy instrument) were measured at baseline, immediately after, and 6 weeks after the intervention. Findings: Health coaching improved QOL, self‐management, patient activation, and self‐efficacy at postintervention and at 12 weeks' follow‐up. Health coaching had a significant indirect effect on QOL through improvements in patient activation. Health coaching exerted a significant indirect effect on self‐management through improvements in self‐efficacy and patient activation. Conclusions: The findings demonstrated that health coaching can effectively improve QOL and self‐management. A health‐coaching intervention can raise self‐efficacy and activation levels through which self‐management and QOL further improve. Clinical Relevance: Health‐coaching strategies can be used to assist patients with early‐stage CKD in reaching their health goals and becoming activated in self‐management of their diseases. [ABSTRACT FROM AUTHOR]

Background: Patient activation has been described as a potential strategy to improve chronic disease self-management. However, the effects of patient activation interventions on psychological and behavioral outcomes have not been systematically evaluated. Purpose: This study was designed to evaluate the effects of patient activation interventions on physiological, psychological, behavioral, and health-related quality of life outcomes in patients with chronic diseases. Methods: We systematically searched four databases (PubMed, Cochrane, CINAHL, and Embase) from inception to September 1, 2017. We identified English- and Chinese-language published reports of randomized controlled trials that evaluated the effects of patient activation interventions for adults with chronic diseases. Study selection, data extraction, and quality assessment were performed by two reviewers independently. We summarized the intervention effects with Hedges's g values and 95% confidence intervals using a random-effects model. We used the Cochrane Handbook to assess the methodological quality of the randomized controlled trials. Results: Twenty-six randomized controlled trials were included in the qualitative synthesis and meta-analysis. In terms of overall study quality, most of the included studies were affected by performance and detection bias. Patient activation interventions produced significant effects on outcomes related to physiological, psychological, behavioral, and health-related quality of life in the context of chronic diseases. The following effect sizes were obtained: (a) physiological, namely, glycated hemoglobin = −0.31 (p <.01), systolic blood pressure = −0.20 (p <.01), diastolic blood pressure = −0.80 (p =.02), body weight = −0.12 (p =.03), and low-density lipoprotein = −0.21 (p =.01); (b) psychological, namely, depression = −0.16 (p <.01) and anxiety = −0.25 (p =.01); (c) behavioral, namely, patient activation = 0.33 (p <.01) and self-efficacy = 0.57 (p <.01); and (d) health-related quality of life = 0.25 (p =.01). Conclusions: Patient activation interventions significantly improve patients' physiological, psychosocial, and behavioral health statuses. Healthcare providers should implement patient activation interventions that tailor support to the individual patients' level of patient activation and strengthen the patients' role in managing their healthcare to improve chronic-disease-related health outcomes. [ABSTRACT FROM AUTHOR]