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Fleming S, Atherton H, McCartney D, et al. Self-screening and non-physician screening for hypertension in communities: A systematic review Am J Hypertens. 2015; 28: 1316-24.
Can non-physician screening and self-screening methods improve the detection of high blood pressure (hypertension) for adults living in the community?
High blood pressure (hypertension) is a preventable condition. Identifying and treating people with high blood pressure reduces the risk of stroke and heart disease. This condition is commonly detected through routine physician screening and individuals who do not regularly visit a doctor or access other primary health care services may not be screened. The aim of the study is to measure whether other methods (non-physician screening and self-screening) may improve the detection of high blood pressure.
This is a systematic review of 73 studies that included community-based screening methods by non-physicians (nurses, medical students, dentists, pharmacists, and lay people) or self-screening for high blood pressure.
Key features of the studies were:
The studies showed a wide range of success of different types of settings or screeners in screening eligible people for raised blood pressure. Detection rates varied greatly within and between different settings and types of screeners.
Screening in pharmacies and mobile sites resulted in the highest proportion of screening of the eligible population. Student screeners resulted in the lowest rates of screening.
Dental sites and mobile sites had lower rates of detecting high blood pressure. The two self-screening studies showed detection rates similar to studies including a variety of screening methods and can be considered an effective screening method for detecting blood pressure.
Of participants with high blood pressure who were referred to seek further medical attention, 44% received a new diagnosis or treatment for hypertension
Community-based screening and self-screening may be an effective way to detect raised blood pressure. There is currently too much variability to make strong conclusions about which type of setting or screener is most effective for different populations.