Pharmacist to improve hypertension management: concordance between Europe and North America
Bibliographic record
Abstract
Abstract Problem Hypertension is highly prevalent but remains poorly controlled, notably in European countries where control rates are frequently worse than in Canada and the United States. One innovative solution for improving hypertension management is team-based care (TBC) with the involvement of a pharmacist. Description of the problem We systematically compared recommendations for TBC in hypertension management in recent European (ESC/ESH), American (ACC/AHA), and Canadian (Hypertension Canada) guidelines and pinpointed potential roles and responsibilities of pharmacists. Results The three guidelines recommend TBC for the management of hypertension, with the ACC/AHA Guidelines giving a stronger emphasis by providing a more exhaustive definition of TBC and by describing the composition of the team. The three guidelines assign roles and responsibilities in hypertension management at the team level, but no firm role is defined for each specific team member. The three guidelines also refer to evidence showing that the pharmacist’s involvement can embrace several activities, that is, diagnosis of hypertension, blood pressure monitoring, medication management, education of patient and health care providers, and communication and organization within the care team. Recent systematic reviews have shown that a pharmacist’s involvement in these steps in hypertension management improves hypertension control compared to standard of care. Lessons International guidelines, including European ones, recommend using TBC in hypertension management, based on strong evidence that a pharmacist’s involvement improves hypertension control. Key messages International guidelines recommend TBC and the involvement of pharmacists to improve hypertension management. Programs and policies to improve hypertension control in European countries should consider the involvement of pharmacists.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.030 | 0.133 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".