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 .
Patient Ability and Willingness to Participate in a Web-Based Intervention to Improve Hypertension Control
Background Patient-shared electronic health records provide opportunities for care outside of office visits . However , those who might benefit may be unable to or choose not to use these re sources , while others might not need them . Objective Electronic Communications and Home Blood Pressure Monitoring ( e-BP ) was a r and omized trial that demonstrated that Web-based pharmacist care led to improved blood pressure ( BP ) control . During recruitment we attempted to contact all patients with hypertension from 10 clinics to determine whether they were eligible and willing to participate . We wanted to know whether particular subgroups , particularly those from vulnerable population s , were less willing to participate or unable to because they lacked computer access . Methods From 2005 to 2006 , we sent invitation letters to and attempted to recruit 9298 patients with hypertension . Eligibility to participate in the trial included access to a computer and the Internet , an email address  , and uncontrolled BP ( BP ≥ 140/90 mmHg ) . Generalized linear models within a modified Poisson regression framework were used to estimate the relative risk ( RR ) of in eligibility due to lack of computer access and of having uncontrolled BP . Results We were able to contact 95.1 % ( 8840/9298 ) of patients . Those refusing participation ( 3032/8840 , 34.3 % ) were significantly more likely ( P < .05 ) to be female , be nonwhite , have lower levels of education , and have Medicaid insurance . Among patients who answered survey questions , 22.8 % ( 1673/7354 ) did not have computer access . Older age , minority race , and lower levels of education were risk factors for lack of computer access , with education as the strongest predictor ( RR 2.63 , 95 % CI 2.30 - 3.01 for those with a high school degree compared to a college education ) . Among hypertensive patients with computer access who were willing to participate , African American race ( RR 1.22 , 95 % CI 1.06 - 1.40 ) , male sex ( RR 1.28 , 95 % CI 1.18 - 1.38 ) , and obesity ( RR 1.53 , 95 % CI 1.31 - 1.79 ) were risk factors for uncontrolled BP . Conclusion Older age , lower socioeconomic status , and lower levels of education were associated with decreased access to and willingness to participate in a Web-based intervention to improve hypertension control . Failure to ameliorate this may worsen health care disparities . Trial Registration Clinical trials.gov NCT00158639 ; http://www . clinical trials.gov/ct2/show/NCT00158639 ( Archived by WebCite at http://www.webcitation.org/5v1jnHaeo
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 .