Team-based care of patients with hypertension improves control of blood pressure
Adding pharmacists and nurses to the teams that work to help patients control their blood pressure (BP) improves the outcomes, according to a new systematic review of intervention studies. Although nurses, pharmacists within primary care clinics, and community pharmacists all served to improve BP control, the greatest impact was seen for interventions that involved community pharmacists.
The researchers found that team-based interventions that provided education about blood pressure medications were associated with a reduction in mean systolic BP (SBP) of 8.75 mm Hg and diastolic BP of 3.6 mm Hg. Pharmacist treatment recommendations were associated with a mean SBP reduction of 9.30 mm Hg; intervention by nurses a 4.80 mm Hg SBP mean reduction; and use of a treatment algorithm, 4.00 mm Hg mean SBP reduction.
Compared with patients who received no intervention, patients who received a nurse intervention were nearly twice as likely to have controlled BP. Patients who received interventions from pharmacists in primary care clinics and community pharmacists were two to nearly three times more likely to have controlled BP.
The findings came from meta-analysis of 37 studies that met the researchers' inclusion criteria out of 583 relevant papers that were published between the beginning of 1970 and early February 2009. New guidelines for control of high blood pressure should recommend that health care organizations consider changes in organizational structure to include important components of team-based care, the researchers conclude. Their study was funded in part by the Agency for Healthcare Research and Quality (HS16094) to the University of Iowa Center for Education and Research on Therapeutics (CERT). For more information on the CERTS program, visit http://www.certs.hhs.gov.
More details are in "The potency of team-based care interventions for hypertension. A meta-analysis," by Barry L. Carter, Pharm.D., Meaghan Rogers, Pharm.D., Jeanette Daly, R.N., Ph.D., and others in the October 26, 2009, Archives of Internal Medicine 161(19), pp. 1748-1755.
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