title: What are the basic self-monitoring components for cardiovascular risk management?
abstract: BACKGROUND
  Self-monitoring is increasingly recommended as a method of managing cardiovascular disease. However, the design, implementation and reproducibility of the self-monitoring interventions appear to vary considerably. We examined the interventions included in systematic reviews of self-monitoring for four clinical problems that increase cardiovascular disease risk.
  
  
  METHODS
  We searched Medline and Cochrane databases for systematic reviews of self-monitoring for: heart failure, oral anticoagulation therapy, hypertension and type 2 diabetes. We extracted data using a pre-specified template for the identifiable components of the interventions for each disease. Data was also extracted on the theoretical basis of the education provided, the rationale given for the self-monitoring regime adopted and the compliance with the self-monitoring regime by the patients.
  
  
  RESULTS
  From 52 randomized controlled trials (10,388 patients) we identified four main components in self-monitoring interventions: education, self-measurement, adjustment/adherence and contact with health professionals. Considerable variation in these components occurred across trials and conditions, and often components were poorly described. Few trials gave evidence-based rationales for the components included and self-measurement regimes adopted.
  
  
  CONCLUSIONS
  The components of self-monitoring interventions are not well defined despite current guidelines for self-monitoring in cardiovascular disease management. Few trials gave evidence-based rationales for the components included and self-measurement regimes adopted. We propose a checklist of factors to be considered in the design of self-monitoring interventions which may aid in the provision of an evidence-based rationale for each component as well as increase the reproducibility of effective interventions for clinicians and researchers.
authors.affiliation: Department of Primary Health Care, The University of Oxford, Headington, UK. alison.ward@dphpc.ox.ac.uk
authors.forename: Alison M
authors.initials: AM
authors.lastname: Ward
authors.forename: Carl
authors.initials: C
authors.lastname: Heneghan
authors.forename: Rafael
authors.initials: R
authors.lastname: Perera
authors.forename: Dan
authors.initials: D
authors.lastname: Lasserson
authors.forename: David
authors.initials: D
authors.lastname: Nunan
authors.forename: David
authors.initials: D
authors.lastname: Mant
authors.forename: Paul
authors.initials: P
authors.lastname: Glasziou
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use*; D015190:Blood Glucose Self-Monitoring; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000628:therapy; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D006973:Hypertension / Q000628:therapy*; D019934:International Normalized Ratio; D016032:Randomized Controlled Trials as Topic; D012648:Self Care
chemical_list: D000925:Anticoagulants