Team-based care increased the proportion of people with controlled BP  and reduced both systolic and diastolic BP , especially when pharmacists and nurses were part of the team .
CONTEXT Uncontrolled hypertension remains a widely prevalent cardiovascular risk factor in the U.S. team-based care , established by adding new staff or changing the roles of existing staff such as nurses and pharmacists to work with a primary care provider and the patient .
Team-based care has the potential to improve the quality of hypertension management .
The goal of this Community Guide systematic review was to examine the effectiveness of team-based care in improving blood pressure ( BP ) outcomes .
Pharmacist-physician comanagement of hypertension and reduction in 24-hour ambulatory blood pressures.
BACKGROUND Pharmacist-physician comanagement of hypertension has been shown to improve office blood pressures ( BPs ) . We sought to describe the effect of such a model on 24-hour ambulatory BPs . METHODS We performed a prospect i ve , cluster-r and omized , controlled clinical trial , enrolling 179 patients with uncontrolled hypertension from 5 primary care clinics in Iowa City , Iowa . Patients were r and omized by clinic to receive pharmacist-physician collaborative management of hypertension ( intervention ) or  usual care ( control ) for a 9-month period . In the intervention group , pharmacists helped patients to identify barriers to BP control , counseled on lifestyle and dietary modifications , and adjusted antihypertensive therapy in collaboration with the patients ' primary care providers . Patients were seen by pharmacists a minimum of every 2 months . Ambulatory BP was measured at baseline and at study end . RESULTS Baseline and end-of- study ambulatory BP profiles were evaluated for 175 patients . Mean ( SD ) ambulatory systolic BPs ( SBPs ) , reported in millimeters of mercury , were reduced more in the intervention group than in the control group : daytime change in ( Δ ) SBP , 15.2 ( 11.5 ) vs 5.5 ( 13.5 ) ( P < .001 ) ; nighttime ΔSBP , 12.2 ( 14.8 ) vs 3.4 ( 13.3 ) ( P < .001 ) ; and 24-hour ΔSBP , 14.1 ( 11.3 ) vs 5.5 ( 12.5 ) ( P < .001 ) . More patients in the intervention group than in the control group had their BP controlled at the end of the study ( 75.0 % vs 50.7 % ) ( P < .001 ) , as defined by overall 24-hour ambulatory BP monitoring . CONCLUSION Pharmacist-physician collaborative management of hypertension achieved consistent and significantly greater reduction in 24-hour BP and a high rate of BP control . Trial Registration clinical trials.gov Identifier : NCT00201045
Team-based care increased the proportion of people with controlled BP  and reduced both systolic and diastolic BP , especially when pharmacists and nurses were part of the team .
CONTEXT Uncontrolled hypertension remains a widely prevalent cardiovascular risk factor in the U.S. team-based care , established by adding new staff or changing the roles of existing staff such as nurses and pharmacists to work with a primary care provider and the patient .
Team-based care has the potential to improve the quality of hypertension management .
The goal of this Community Guide systematic review was to examine the effectiveness of team-based care in improving blood pressure ( BP ) outcomes .