Journal article
The Potency of Team-Based Care Interventions for Hypertension A Meta-analysis
Archives of internal medicine (1960), Vol.169(19), pp.1748-1755
10/26/2009
DOI: 10.1001/archinternmed.2009.316
PMCID: PMC2882164
PMID: 19858431
Abstract
Background: Team-based care is the strategy that has had the greatest effect on improving blood pressure (BP). The purpose of this systematic review was to determine the potency of interventions for BP involving nurses or pharmacists.
Methods: A MEDLINE search for controlled clinical trials that involved a nurse or pharmacist intervention was conducted. Mean reductions in systolic (S) and diastolic (D) BP were determined by 2 reviewers who independently abstracted data and classified the different intervention components.
Results: Thirty-seven articles met the inclusion criteria. Education about BP medications was significantly associated with a reduction in mean BP (-8.75/-3.60 mm Hg). Other strategies that had large effect sizes on SBP include pharmacist treatment recommendations (-9.30 mm Hg), intervention by nurses (-4.80 mm Hg), and use of a treatment algorithm (-4.00 mm Hg). The odds ratios (95% confidence intervals) for controlled BP were: nurses, 1.69 (1.48-1.93); pharmacists within primary care clinics, 2.17 (1.75-2.68); and community pharmacists, 2.89 (1.83-4.55). Mean (SD) reductions in SBP were: nursing studies, 5.84 (8.05) mm Hg; pharmacists in clinics, 7.76(7.81) mm Hg; and community pharmacists, 9.31 (5.00) mm Hg. There were no significant differences between the nursing and pharmacy studies (P >= .19).
Conclusions: Team-based care was associated with improved BP control, and individual components of the intervention appeared to predict potency. Implementation of new hypertension guidelines should consider changes in health care organizational structure to include important components of team-based care.
Details
- Title: Subtitle
- The Potency of Team-Based Care Interventions for Hypertension A Meta-analysis
- Creators
- Barry L. Carter - University of IowaMeaghan Rogers - University of IowaJeanette Daly - Univ Iowa, Dept Family Med, Roy J & Lucille A Carver Coll Med, Iowa City, IA 52242 USAShimin Zheng - Univ Iowa, Dept Family Med, Roy J & Lucille A Carver Coll Med, Iowa City, IA 52242 USAPaul A. James - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Archives of internal medicine (1960), Vol.169(19), pp.1748-1755
- DOI
- 10.1001/archinternmed.2009.316
- PMID
- 19858431
- PMCID
- PMC2882164
- NLM abbreviation
- Arch Intern Med
- ISSN
- 0003-9926
- eISSN
- 1538-3679
- Publisher
- American Medical Association
- Number of pages
- 14
- Grant note
- Veterans Health Administration Health Services Research and Development Service; US Department of Veterans Affairs U18HS016094 / AGENCY FOR HEALTHCARE RESEARCH AND QUALITY; United States Department of Health & Human Services; Agency for Healthcare Research & Quality US Department of Veterans Affairs HL070740 / National Heart, Lung, and Blood Institute; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI) HFP 04-149 / Center for Research in Implementation in Innovative Strategies in Practice R01HL070740 / NATIONAL HEART, LUNG, AND BLOOD INSTITUTE; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI) 5U18HSO16094 / Agency for Healthcare Research and Quality Centers for Education and Research on Therapeutics; United States Department of Health & Human Services; Agency for Healthcare Research & Quality
- Language
- English
- Date published
- 10/26/2009
- Academic Unit
- Family and Community Medicine; Pharmacy Practice and Science
- Record Identifier
- 9984627309102771
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