{"id":"ec8b536c45f3","type":"article","url":"https://hartvaat.nl/2023/06/01/team-based-care-bij-hypertensie-meta-analyse-bevestigt-effectiviteit-en-kostenef/","title":"Team-based care bij hypertensie: meta-analyse bevestigt effectiviteit en kosteneffectiviteit","title_en":"Effectiveness and Cost-Effectiveness of Team-Based Care for Hypertension: A Meta-Analysis and Simulation Study.","category":"hypertensie","category_label":"Hypertensie","professions":["apotheker","cardioloog","huisarts"],"tags":["bloeddrukbehandeling","farmaco-economie","hartrevalidatie"],"journal":"Hypertension (Dallas, Tex. : 1979)","doi":"10.1161/HYPERTENSIONAHA.122.20292","source_url":"https://doi.org/10.1161/HYPERTENSIONAHA.122.20292","authors":["Kelsey B Bryant","Aditi S Rao","Laura P Cohen","Nadine Dandan","Ian M Kronish","Nikita Barai","Valy Fontil","Yiyi Zhang","Andrew E Moran","Brandon K Bellows"],"significance":7,"published":"2023-06-01","source_date":"2023-06-01","image":"","kennis":["https://hartvaat.nl/kennis/farmacologie/betablokkers-cardiale-indicaties/","https://hartvaat.nl/kennis/hypertensie/calciumantagonisten-hypertensie/"],"congress":"","summary_en":"This meta-analysis and simulation study showed that team-based care for hypertension significantly improves blood pressure control and is cost-effective, supporting the implementation of pharmacist and nurse-led hypertension management models.","created":"2026-07-03T10:30:24Z","updated":"2026-07-03T13:29:28Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Meta-analyse en simulatiestudie toonden dat teamgebaseerde zorg de bloeddrukcontrole significant verbetert en kosteneffectief is. Multidisciplinaire samenwerking (arts, verpleegkundige, apotheker) is een bewezen strategie voor hypertensiemanagement.","abstract_original":"BACKGROUND: Team-based care (TBC), a team of ≥2 healthcare professionals working collaboratively toward a shared clinical goal, is a recommended strategy to manage blood pressure (BP). However, the most effective and cost-effective TBC strategy is unknown. METHODS: A meta-analysis of clinical trials in US adults (aged ≥20 years) with uncontrolled hypertension (≥140/90 mm Hg) was performed to estimate the systolic BP reduction for TBC strategies versus usual care at 12 months. TBC strategies were stratified by the inclusion of a nonphysician team member who could titrate antihypertensive medications. The validated BP Control Model-Cardiovascular Disease Policy Model was used to project the expected BP reductions out to 10 years and simulate cardiovascular disease events, direct healthcare costs, quality-adjusted life years, and cost-effectiveness of TBC with physician and nonphysician titration. RESULTS: Among 19 studies comprising 5993 participants, the 12-month systolic BP change versus usual care was -5.0 (95% CI, -7.9 to -2.2) mm Hg for TBC with physician titration and -10.5 (-16.2 to -4.8) mm Hg for TBC with nonphysician titration. Relative to usual care at 10 years, TBC with nonphysician titration was estimated to cost $95 (95% uncertainty interval, -$563 to $664) more per patient and gain 0.022 (0.003-0.042) quality-adjusted life years, costing $4400/quality-adjusted life year gained. TBC with physician titration was estimated to cost more and gain fewer quality-adjusted life years than TBC with nonphysician titration. CONCLUSIONS: TBC with nonphysician titration yields superior hypertension outcomes compared with other strategies and is a cost-effective way to reduce hypertension-related morbidity and mortality in the United States."}