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September 16, 2019The Lancet Global HealthOpen Access

Task sharing with non-physician health-care workers for management of blood pressure

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Key result

Task sharing with non-physician health-care workers is a viable strategy for managing hypertension, though intervention heterogeneity and the white coat effect may confound reported SBP reductions.

Why the study?

Does task sharing with non-physician health-care workers reduce systolic blood pressure in adults with hypertension in low-income and middle-income countries?

Population

Adults with hypertension in low-income and middle-income countries

Comparison

Task sharing with non-physician health-care… vs Physician-only care

Design

Editorial

Authors

BCBennett Jun Kang ChoyNuffield Orthopaedic CentreKGKrishanth GanesanLeeds Teaching Hospitals NHS TrustNFNien Sze FongUniversity of Sheffield

Discussion

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Implication

This correspondence highlights that while task sharing with non-physician healthcare workers reduces blood pressure, future analyses should separate pharmacological from lifestyle interventions and account for the white coat effect.

Structured PICO

Does task sharing with non-physician health-care workers reduce systolic blood pressure in adults with hypertension in low-income and middle-income countries?

P
Population
Adults with hypertension in low-income and middle-income countries
I
Intervention
Task sharing with non-physician health-care workers for the management of hypertension (including lifestyle and pharmacological interventions)
C
Comparator
Physician-only care
O
Outcome
Reduction of systolic blood pressure (SBP)surrogate

This correspondence highlights that while task sharing with non-physician healthcare workers reduces blood pressure, future analyses should separate pharmacological from lifestyle interventions and account for the white coat effect.

Limitations

  • Inconsistencies in comparing lifestyle versus pharmacological interventions may cause unreliable results.
  • The white coat effect is unaccounted for and could result in higher SBP readings in physician-led care.
  • Initial diagnosis and initiation of pharmacological management should still be done by a physician to rule out secondary causes.
  • Inconsistencies in comparing lifestyle versus pharmacological interventions
  • Unaccounted white coat effect, which is more pronounced with physicians than nurses
  • Initial diagnosis and pharmacological initiation should still be done by a physician to rule out secondary causes

Cite This Study

Choy et al. (2019) conducted a letter in Hypertension. Task sharing with non-physician health-care workers vs. Physician-only care was evaluated on Reduction in systolic blood pressure (SBP). Task sharing with non-physician health-care workers is a viable strategy for managing hypertension, though intervention heterogeneity and the white coat effect may confound reported SBP reductions.

synapsesocial.com/papers/6a70738ee71d69abee089f27https://doi.org/10.1016/s2214-109x(19)30325-0
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Interventions used to improve control of blood pressure in patients with hypertension2010 · 675 citations
  2. 2Comparison of agreement between different measures of blood pressure in primary care and daytime ambulatory blood pressure2002 · 172 citations
  3. 3Doctors record higher blood pressures than nurses: systematic review and meta-analysis2014 · 64 citations
  4. 4Task Force V1999 · 104 citations
  5. 5How should we measure blood pressure in the doctorʼs office?2001 · 50 citations