Patients' control of blood pressure improved when their care was provided by a team of health care professionals—a primary care provider supported by a pharmacist, nurse, dietitian, social worker, or community health worker—rather than by a single physician, says the Community Preventive Services Task Force following a review of 77 studies on team-based care. The task force is an independent, nonfederal, uncompensated body of public health and prevention experts, whose members are appointed by the Centers for Disease Control and Prevention.
The collection of studies showed that team-based care helped increase the proportion of patients with controlled blood pressure, led to a decrease in both systolic and diastolic blood pressure, and improved outcomes in patients who had diabetes and elevated blood lipids.
Team members supplemented the activities of the primary care provider by providing support and sharing responsibility for hypertension care. Support and responsibility included medication management, patient follow-up, and helping the patient adhere to his or her blood pressure control plan, including monitoring blood pressure routinely, taking medications as prescribed, reducing sodium in the diet, and increasing physical activity, says the task force.
Team-based care is a central pillar of the Million Hearts initiative, launched by the Department of Health and Human Services in September 2011. Million Hearts is a national, public-private initiative to prevent 1 million heart attacks and strokes over 5 years. The initiative is aligned with the Healthy People 2020 goal to reduce the number of people in the US with high blood pressure. Blood pressure control is 1 of 4 health behaviors targeted by the initiative—the others are aspirin as appropriate, cholesterol management, and smoking cessation.
Many opportunities and challenges are on the horizon for physical therapists as organizations attempt to eliminate health care silos and integrate patient care. In an effort to prepare physical therapists for health care integration, APTA has produced a video series that highlights innovative clinical practice models and the roles that physical therapists can play in today's health care environment. The videos and accompanying handouts can help physical therapists gain insight and inspiration as they look for ways to become involved in new models of care delivery.
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