Team-based Care for Improving Hypertension Management Among Outpatients
Bibliographic record
Abstract
Abstract Background Innovative models of care are needed to reduce poor blood pressure (BP) control in European countries. The TBC-HTA study evaluated the effects of an interprofessional team-based care (TBC) intervention, involving nurses, community pharmacists, and physicians, on BP control compared to usual care. Methods We conducted a pragmatic randomized controlled study in ambulatory clinics and community pharmacies in Lausanne and Geneva, Switzerland (ClinicalTrials.gov: NCT02511093). Uncontrolled treated hypertensive patients were randomized to TBC (N = 46) or usual care (UC: N = 43). The TBC intervention was led over 6 months. Nurses and pharmacists met patients every 6 weeks to measure BP, assess lifestyle and medication adherence, and provide health education. After each visit, they wrote a report with recommendations to the physician who could adjust antihypertensive therapy accordingly. The outcome was ambulatory BP measured at 6 and 12 months. Results A total of 60 men and 29 women [mean (SD) age: 61(12) year; mean (SD) number of antihypertensive drugs: 2 (1)] were included. At baseline, mean (SD) BP was 144(10)/90(8) and 147(12)/87(11) mmHg in the TBC and UC care groups. 76 patients were followed up to 12 months. At 6 months, the between-group difference in mean BP was -3/+2 mmHg [95% CI: -10 to + 5 / -2 to + 5]; BP control was 38% in the TBC group and 33% in the UC group, respectively. At 12 months, the between-group difference in mean BP was -8/-3 mmHg [95% CI: -14 to -1/-7 to + 1]; BP control was 34% in the TBC group and 20% in the UC group, respectively. Conclusions This TBC intervention helped long-term BP control among hypertensive outpatients in Switzerland. In line with recent European guidelines (ESC/ESH), this type of care should be more widely implemented. Key messages A TBC of hypertension helped control BP in a Swiss healthcare setting. Policymakers should evaluate how to implement such intervention.
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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 | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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".