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 .
Nurse-led adherence support in hypertension: a randomized controlled trial.
BACKGROUND Lack of medication adherence is a common reason for poor control of blood pressure in the community , increasing the risk of heart attacks and strokes . OBJECTIVE To evaluate the effect of nurse-led adherence support for people with uncontrolled high blood pressure compared with usual care . METHODS We recruited 245 women and men with uncontrolled hypertension ( > or = 150/90 mmHg ) from 21 general practice s in Bristol , UK . Participants were r and omized to receive  nurse-led adherence support  or usual care alone . Main outcome measures were  adherence to medication ( ' timing compliance ' ) and blood pressure . RESULTS Mean baseline timing compliance ( + /- SD ) was high in both the intervention ( 90.8 + /- 15.6 % ) and the control group ( 94.5 + /- 7.6 % ) . There was no evidence of an effect of the intervention on timing compliance at follow-up ( adjusted difference in means -1.0 % ; 95 % confidence interval ( CI ) -5.1 to 3.1 ) . There was also no difference at follow-up between the groups with regard to systolic blood pressure ( -2.7 mmHg ; 95 % CI -7.2 to 1.8 ) or diastolic blood pressure ( 0.2 mmHg ; 95 % CI -1.9 to 2.3 ) . Projected costs for the primary care sector per consultation were 6.60 pound sterling for the intervention compared with 5.08 pound sterling for usual care . CONCLUSION In this study , adherence to blood pressure medication was much higher than previously reported . There was no evidence of an effect of nurse-led adherence support on medication adherence or blood pressure compared with usual care . Nurse-led adherence support was also more expensive from a primary care perspective
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 .