Canadian Pharmacists Journal - May/June 2019 - 181

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Table 1 American, European and Canadian 2017-2018 recommendations regarding team-based care in
hypertension management

aCC/aHa 2017 Guideline for the
Prevention, Detection, evaluation
and Management of High blood
Pressure in adults13

eSC/eSH 2018 guidelines
for the management of
arterial hypertension15

Hypertension Canada's
2017 Guidelines
for Diagnosis, Risk
assessment, Prevention
and Treatment of
Hypertension in adults14

Members of the
care team

TBC for hypertension includes the
patient, the patient's primary care
provider and other professionals,
such as cardiologists, nurses,
pharmacists, physician assistants,
dietitians, social workers and
community health workers.
These professionals complement
the activities of the primary
care provider by providing
process support and sharing the
responsibilities of hypertension
care.

No explicit definition of TBC,
but guidelines mention
that collaboration (of
physician) with other
health care providers,
especially nurses and
pharmacists, may improve
drug adherence in
hypertension.

No explicit definition of TBC,
but guidelines recommend
both involving the
patients in their treatment
to improve adherence
and coordinating with
pharmacists and worksite health care givers
to improve monitoring
of adherence with
pharmacological and
lifestyle modification
prescriptions.

Formal definition
of TBC in
management of
hypertension

TBC to improve BP control is a health
systems-level, organizational
intervention that incorporates a
multidisciplinary team to improve
the quality of hypertension care for
patients.

No explicit definition.

No explicit definition.

Steps in
management of
hypertension,
where TBC is
recommended

A TBC approach is patient-centred
and is frequently implemented as
part of a multifaceted approach,
with systems support for clinical
decision-making (i.e., treatment
algorithms), collaboration,
adherence to prescribed regimen,
BP monitoring and patient selfmanagement. Follow-up and
monitoring after initiation of drug
therapy for hypertension control
should include systematic strategies
to help improve BP, including use of
HBPM, TBC and telehealth strategies.

Nurses and pharmacists
[have an important
role] in the education,
support and follow-up
of treated hypertensive
patients (part of the
overall strategy to improve
BP control). Increasing
the integration among
health care providers
with the involvement of
pharmacists and nurses
increases drug adherence.

A multidisciplinary team
approach is recommended
for improving adherence
to an antihypertensive
prescription and in
strategies targeting weight
loss (dietary education,
increased physical
activity and behavioural
intervention).

No recommendation.

No recommendation.

Specific patient
situations, where
TBC is specifically
recommended

(continued)

C P J / R P C  *  M ay / J u n e  2 0 1 9  *  V O L  1 5 2 ,  N O  3 

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