Impact of patient care teams on blood pressure control in patients with hypertension: a systematic review and meta-analysis.

Abstract

Hypertension is a significant risk factor for cardiovascular diseases, with its global prevalence doubling over the past three decades. Despite advancements in antihypertensive therapies, approximately 50% of patients with hypertension fail to achieve their target blood pressure (BP) levels, underscoring the need for innovative care strategies. Patient care teams comprising multidisciplinary healthcare providers have shown promise in improving BP management. This systematic review and meta-analysis were aimed at evaluating the effectiveness of patient care teams involving physicians in hypertension management. To this end, PubMed, Cochrane CENTRAL, and IchuShi-Web were comprehensively searched and 61 randomized controlled trials including 64,857 participants were identified. Compared with usual care, interventions by patient care teams significantly reduced office systolic BP (mean difference: -6.31 mmHg; 95% confidence interval: -7.71 to -4.90) and decreased the risk of uncontrolled BP by 27% (risk ratio: 0.73; 95% confidence interval: 0.68-0.79). Subgroup analyses demonstrated consistent BP reductions across various team leadership roles, such as physicians, nurses, and pharmacists, and across different intervention durations. These findings highlight the effectiveness of team-based BP management in achieving improved BP control, regardless of team composition or the follow-up period. Multidisciplinary care offers a viable approach to addressing the unmet needs of patients with hypertension, potentially improving cardiovascular outcomes. This evidence supports integrating patient care teams into hypertension management, particularly in settings requiring physician oversight. Future research should focus on refining team structures and tailoring interventions to diverse healthcare environments to enhance their impact.