title: Team-based care and improved blood pressure control: a community guide systematic review.
abstract: BACKGROUND
  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.
  
  
  METHODS
  An existing systematic review (search period, January 1980-July 2003) assessing team-based care for BP control was supplemented with a Community Guide update (January 2003-May 2012). For the Community Guide update, two reviewers independently abstracted data and assessed quality of eligible studies.
  
  
  RESULTS
  Twenty-eight studies in the prior review (1980-2003) and an additional 52 studies from the Community Guide update (2003-2012) qualified for inclusion. Results from both bodies of evidence suggest that team-based care is effective in improving BP outcomes. From the update, the proportion of patients with controlled BP improved (median increase=12 percentage points); systolic BP decreased (median reduction=5.4 mmHg); and diastolic BP also decreased (median reduction=1.8 mmHg).
  
  
  CONCLUSIONS
  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. Findings are applicable to a range of U.S. settings and population groups. Implementation of this multidisciplinary approach will require health system-level organizational changes and could be an important element of the medical home.
authors.affiliation: Community Guide Branch, Division of Epidemiology, Analysis, and Library Services, Center for Surveillance, Epidemiology, and Laboratory Services, CDC.
authors.forename: Krista K
authors.initials: KK
authors.lastname: Proia
authors.affiliation: Community Guide Branch, Division of Epidemiology, Analysis, and Library Services, Center for Surveillance, Epidemiology, and Laboratory Services, CDC. Electronic address: athota@cdc.gov.
authors.forename: Anilkrishna B
authors.initials: AB
authors.lastname: Thota
authors.affiliation: Community Guide Branch, Division of Epidemiology, Analysis, and Library Services, Center for Surveillance, Epidemiology, and Laboratory Services, CDC.
authors.forename: Gibril J
authors.initials: GJ
authors.lastname: Njie
authors.affiliation: Community Guide Branch, Division of Epidemiology, Analysis, and Library Services, Center for Surveillance, Epidemiology, and Laboratory Services, CDC.
authors.forename: Ramona K C
authors.initials: RK
authors.lastname: Finnie
authors.affiliation: Community Guide Branch, Division of Epidemiology, Analysis, and Library Services, Center for Surveillance, Epidemiology, and Laboratory Services, CDC.
authors.forename: David P
authors.initials: DP
authors.lastname: Hopkins
authors.affiliation: Community Guide Branch, Division of Epidemiology, Analysis, and Library Services, Center for Surveillance, Epidemiology, and Laboratory Services, CDC.
authors.forename: Qaiser
authors.initials: Q
authors.lastname: Mukhtar
authors.affiliation: HealthPartners, Minneapolis, Minnesota.
authors.forename: Nicolaas P
authors.initials: NP
authors.lastname: Pronk
authors.affiliation: American Medical Association , Minneapolis, Minnesota.
authors.forename: Donald
authors.initials: D
authors.lastname: Zeigler
authors.affiliation: HealthPartners, Minneapolis, Minnesota.
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Kottke
authors.affiliation: Emory University, Georgia Medical Care Foundation, Atlanta, Georgia.
authors.forename: Kimberly J
authors.initials: KJ
authors.lastname: Rask
authors.affiliation: Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Daniel T
authors.initials: DT
authors.lastname: Lackland
authors.affiliation: South Carolina Department of Health & Environmental Control, Columbia.
authors.forename: Joy F
authors.initials: JF
authors.lastname: Brooks
authors.affiliation: Rush College of Nursing, Chicago, Illinois.
authors.forename: Lynne T
authors.initials: LT
authors.lastname: Braun
authors.affiliation: Community Guide Branch, Division of Epidemiology, Analysis, and Library Services, Center for Surveillance, Epidemiology, and Laboratory Services, CDC.
authors.forename: Tonya
authors.initials: T
authors.lastname: Cooksey
mesh_terms: D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000628:therapy*; D009726:Nurses / Q000458:organization & administration; D010348:Patient Care Team / Q000458:organization & administration* / Q000592:standards; D010595:Pharmacists / Q000458:organization & administration; D011787:Quality of Health Care; D012307:Risk Factors; D014481:United States / Q000453:epidemiology