Why the study?
LMICs bear a disproportionate burden of CVD and team-based care improves BP control, but the efficacy across different levels of team-based care complexity needed to be tested.
Does team-based care and task-sharing improve blood pressure control in patients with hypertension in LMICs?
Meta-Analysis (n=31,895)
Yes
Does team-based care and task-sharing improve blood pressure control in patients with hypertension in LMICs?
Team-based care and task-sharing interventions effectively lower systolic blood pressure for hypertension management in low- and middle-income countries.
Answers are grounded in this paper and cite their sources.
Supports team-based hypertension care in LMICs; extends evidence to resource-limited settings.
Background: Low- and middle-income countries (LMICs) bear a disproportionately higher burden of Cardiovascular Disease (CVD). Team-based care approach adds capacity to improve blood pressure (BP) control. This updated review aimed to test team-based care efficacy at different levels of hypertension team-based care complexity. Methods: We searched PubMed, Embase, Cochrane, and CINAHL for newer articles on task-sharing interventions to manage hypertension in LMICs. Levels of tasks complexity performed by healthcare workers added to the clinical team in hypertension control programs were categorized as administrative tasks (level 1), basic clinical tasks (level 2), and/or advanced clinical tasks (level 3). Meta-analysis using an inverse variance weighted random-effects model summarized trial-based evidence on the efficacy of team-based care on BP control, compared with usual care. Findings: = 77.3%). Interpretation: Overall, team-based hypertension care interventions consistently contributed to lower systolic BP compared to usual care; the effect size varies by the clinical training of the healthcare team members. Funding: Resolve To Save Lives (RTSL) Vital Strategies, Danielle Cazabon, Andrew E. Moran, Yvonne Commodore-Mensah receive salary support from Resolve to Save Lives, an initiative of Vital Strategies. Resolve to Save Lives is jointly supported by grants from Bloomberg Philanthropies, the Bill & Melinda Gates Foundation, and Gates Philanthropy Partners, which is funded with support from the Chan Zuckerberg Foundation.
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Ogungbe et al. (2022) conducted a meta-analysis in Hypertension (n=31,895). Team-based care (task-sharing) vs. Usual care was evaluated on Change in systolic blood pressure (MD -4.6 mm Hg, 95% CI -5.8, -3.4, p=<0.001).
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