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Cost-Effectiveness and Challenges of Implementing Intensive Blood Pressure Goals and Team-Based Care

  • Implementation to Increase Blood Pressure Control: What Works? (J Brettler and K Reynolds, Section Editors)
  • Published:
Current Hypertension Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Review the effectiveness, cost-effectiveness, and implementation challenges of intensive blood pressure (BP) control and team-based care initiatives.

Recent Findings

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.

Summary

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.

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  1. Department of Pharmacy, Kaiser Permanente Colorado, Aurora, CO, USA

    Catherine G. Derington

  2. Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, USA

    Catherine G. Derington

  3. Department of Population Health Sciences, School of Medicine, University of Utah, 295 Chipeta Way, Salt Lake City, UT, 84112, USA

    Jordan B. King & Adam P. Bress

  4. Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO, 84112, USA

    Jordan B. King

  5. Division of General Medicine, Department of Medicine, Columbia University Medical Center, New York, NY, USA

    Kelsey B. Bryant, Andrew E. Moran & Brandon K. Bellows

  6. Byrdine F. Lewis College of Nursing & Health Professions, Georgia State University, Atlanta, GA, USA

    Blake T. McGee

  7. MedStar Washington Hospital Center, Washington, DC, USA

    William S. Weintraub

Authors
  1. Catherine G. Derington
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  2. Jordan B. King
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  3. Kelsey B. Bryant
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  4. Blake T. McGee
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  5. Andrew E. Moran
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  6. William S. Weintraub
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  7. Brandon K. Bellows
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  8. Adam P. Bress
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Correspondence to Adam P. Bress.

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Conflict of Interest

Dr. Bress receives support to his institution from Amarin Corporation, Novartis, and Amgen unrelated to the current manuscript. The other authors declare no conflicts of interest relevant to this manuscript.

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This article is part of the Topical Collection on Implementation to Increase Blood Pressure Control: What Works?

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Derington, C.G., King, J.B., Bryant, K.B. et al. Cost-Effectiveness and Challenges of Implementing Intensive Blood Pressure Goals and Team-Based Care. Curr Hypertens Rep 21, 91 (2019). https://doi.org/10.1007/s11906-019-0996-x

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  • DOI: https://doi.org/10.1007/s11906-019-0996-x

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