Blood pressure control-implementing a team approach

Abstract

There are many types of quality improvement strategies that can be used to improve blood pressure (BP) control. Team-based care models have achieved much higher rates of BP control than other strategies. Team-based care interventions have been shown to lead to improved 24-hour BP control and control is sustained when specific interventions are discontinued. In some cases, collaborative care is effective because there is greater opportunity to focus on behavioral approaches to improve patient self-efficacy and resulting medication adherence. In many cases, however, high BP control rates are achieved because of reduced clinical inertia and much more attention to frequent medication titration. In order to deliver team-based care for hypertension, the entire healthcare delivery system may need to be restructured to focus on chronic care rather than on acute, episodic care. The team can implement strategies to ensure adherence to office visits through reminders and telephone calls for missed appointments. Because healthcare teams can substantially improve outcomes, pay for performance and other approaches will make such approaches much more attractive to providers and health systems. Physicians and health system administrators should determine how they can incorporate team-based care for patients with hypertension. © Touchbriefings 2011.