Commentary: When managing health becomes a struggle – lessons from a systematic review on self-management in CVD

Ineffective health self-management: a systematic review and meta-analysis of aetiological factors in adults with cardiovascular conditions (Cruz Neto and de Oliveira Lopes, 2025).This rigorous systematic review and meta-analysis provide critical insights into the factors contributing to inadequate health self-management among adults living with cardiovascular disease (CVD) (Cruz Neto and de Oliveira Lopes, 2025).CVD remains a formidable global health challenge, with far-reaching impacts that extend beyond clinical outcomes to influence the social, economic, and emotional well-being of affected individuals.Each year, millions are affected worldwide, with consequences that transcend morbidity and mortality to include profound societal implications (Mensah et al., 2023).Although advances in medical science have improved survival and quality of life, these benefits depend heavily on patients' capacity for effective self-management.The ability to monitor symptoms, adhere to prescribed treatments, implement lifestyle modifications, and navigate complex healthcare systems often determines treatment success (Jensen et al., 2020).When these processes falter, ineffective health self-management emerges, compromising both clinical outcomes and quality of life (Herdman et al., 2024).Drawing on evidence from 45 studies, the review paints a vivid picture of personal, social, and structural influences on patients' ability to manage their health.A key strength of the review is its categorisation of these factors into four overlapping groups: predisposing, disabling, precipitating and reinforcing; based on the theory of causation and validation of nursing diagnoses.This framework highlights that self-management is not an isolated behaviour but the product of a dynamic interplay of interwoven influences (De Oliveira Lopes et al., 2017).