Department of Pharmacy, Kaiser Permanente Colorado, Aurora, CO, USA.
Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, USA.
Curr Hypertens Rep. 2019 Nov 7;21(12):91. doi: 10.1007/s11906-019-0996-x.
Review the effectiveness, cost-effectiveness, and implementation challenges of intensive blood pressure (BP) control and team-based care initiatives.
Intensive BP control is an effective and cost-effective intervention; yet, implementation in routine clinical practice is challenging. Several models of team-based care for hypertension management have been shown to be more effective than usual care to control BP. Additional research is needed to determine the cost-effectiveness of team-based care models relative to one another and as they relate to implementing intensive BP goals. As a focus of healthcare shifts to value (i.e., cost, effectiveness, and patient preferences), formal cost-effectiveness analyses will inform which team-based initiatives hold the highest value in different healthcare settings with different populations and needs. Several challenges, including clinical inertia, financial investment, and billing restrictions for pharmacist-delivered services, will need to be addressed in order to improve public health through intensive BP control and team-based care.
综述强化血压（BP）控制和基于团队的护理干预措施的有效性、成本效益及实施挑战。
强化 BP 控制是一种有效且具有成本效益的干预措施；然而，在常规临床实践中实施具有挑战性。多项高血压管理的团队护理模式已被证明比常规护理更能有效控制血压。需要进一步研究来确定团队护理模式相对于彼此以及与实施强化 BP 目标相关的成本效益。随着医疗保健重点转移到价值（即成本、效果和患者偏好），正式的成本效益分析将告知在不同人群和需求的不同医疗保健环境中，哪些基于团队的干预措施具有最高的价值。为了通过强化 BP 控制和基于团队的护理来改善公众健康，需要解决包括临床惰性、财务投资和药剂师提供服务的计费限制在内的几个挑战。
