The Hypertension Team: The Role of the Pharmacist, Nurse, and Teamwork in Hypertension Therapy

Authors

  • Barry L. Carter Pharm D,

    1. From the Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City, IA;
    2. the Department of Family Medicine, College of Medicine, University of Iowa, Iowa City, IA;
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  • Hayden B. Bosworth PhD,

    1. the Department of Medicine, School of Medicine and School of Nursing, Duke University, Durham, NC;
    2. the Department of Psychiatry and Behavioral Sciences, School of Medicine and School of Nursing, Duke University, Durham, NC;
    3. the Durham VAMC, Center for Health Services Research in Primary Care, Durham, NC;
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  • Beverly B. Green MD, MPH

    1. the Group Health Research Institute, Seattle, WA;
    2. Group Health Permanente, Seattle, WA;
    3. the University of Washington School of Medicine, Seattle, WA
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Barry L. Carter, Pharm D, Department of Pharmacy Practice and Science, College of Pharmacy, Room 527, University of Iowa, Iowa City, IA 52242
E-mail:barry-carter@uiowa.edu

Abstract

J Clin Hypertens (Greenwich).

Team-based care is one of the key components of the patient-centered medical home. Studies have consistently demonstrated that teams involving pharmacists or nurses in patient management can significantly improve blood pressure control. These findings have been demonstrated in several meta-analyses and systematic reviews. These reviews have generally found that team-based care can reduce systolic blood pressure by 4–10 mm Hg over usual care. However, these reviews have also concluded that many of the studies had various limitations and that additional research should be conducted. The present state of the art review paper will highlight newer studies, many of which were funded by the National Institutes of Health. Newer strategies involve telephone and/or web-based management which is an evolving area to improve blood pressure control in large populations. Social media and other technology is currently being investigated to assist pharmacists or nurses in communicating with patients to improve hypertension management. Few cost-effectiveness analyses have been performed but generally have found favorable costs for team-based care when considering the potential to reduce morbidity and mortality. The authors will suggest additional research that needs to be conducted to help evaluate strategies to best implement team-based care to improve blood pressure management.

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