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 .
Effect of patient withdrawal on a study evaluating pharmacist management of hypertension.
STUDY OBJECTIVES To examine potential threats to internal and external study validity caused by differential patient withdrawal from a r and omized controlled trial evaluating pharmacist management of hypertension , to compare the characteristics of patients who withdrew with those of patients who completed the study , and to identify characteristics that predispose patients to withdraw from hypertension management . DESIGN Prospect i ve , r and omized , comparative study . SETTING Network of primary care clinics . PATIENTS Four hundred sixty-three patients with a diagnosis of hypertension and a last documented systolic blood pressure of 160 mm Hg or greater and /or diastolic blood pressure of 100 mm Hg or greater . INTERVENTION Patients were r and omly allocated to the pharmacist intervention or usual-care ( control ) group . Those in the pharmacist intervention group were collaboratively managed by a primary care clinical pharmacy specialist and their primary care provider .  Patients in the control group  received usual care from only their primary care provider . MEASUREMENTS AND MAIN RESULTS Of the 463 patients , 191 ( 41 % ) withdrew from the study after r and omization and 272 ( 59 % ) completed the study . Patients who withdrew from the pharmacist intervention group were similar to patients who withdrew from the usual-care group with respect to age , sex , insurance status , and chronic conditions . Patients who smoked or had commercial insurance were more likely to withdraw from the study than the other participants . However , multivariate analysis of all variables , when adjusted for the effect of the intervention , revealed that insurance status was the only variable associated with a heightened probability of withdrawal ( p=0.002 ) . CONCLUSION Although this study had a high withdrawal rate , between-group patient characteristics remained balanced . Therefore , internal validity was preserved , and outcomes from the study groups could be reliably compared . A lack of significant differences between patients who withdrew versus those who completed , with the exception of insurance status , suggests that external validity was not jeopardized
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 .