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

  • Catherine G. Derington
  • Jordan B. King
  • Kelsey B. Bryant
  • Blake T. McGee
  • Andrew E. Moran
  • William S. Weintraub
  • Brandon K. Bellows
  • Adam P. BressEmail author
Implementation to Increase Blood Pressure Control: What Works? (J Brettler and K Reynolds, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Implementation to Increase Blood Pressure Control: What Works?


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.


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.


Cost-effectiveness Patient care team Hypertension Blood pressure Pharmacists Nurses 


Compliance with Ethical Standards

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.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Catherine G. Derington
    • 1
    • 2
  • Jordan B. King
    • 3
    • 4
  • Kelsey B. Bryant
    • 5
  • Blake T. McGee
    • 6
  • Andrew E. Moran
    • 5
  • William S. Weintraub
    • 7
  • Brandon K. Bellows
    • 5
  • Adam P. Bress
    • 3
    Email author
  1. 1.Department of PharmacyKaiser Permanente ColoradoAuroraUSA
  2. 2.Department of Clinical PharmacyUniversity of Colorado Skaggs School of Pharmacy and Pharmaceutical SciencesAuroraUSA
  3. 3.Department of Population Health Sciences, School of MedicineUniversity of UtahSalt Lake CityUSA
  4. 4.Institute for Health Research, Kaiser Permanente ColoradoAuroraUSA
  5. 5.Division of General Medicine, Department of MedicineColumbia University Medical CenterNew YorkUSA
  6. 6.Byrdine F. Lewis College of Nursing & Health ProfessionsGeorgia State UniversityAtlantaUSA
  7. 7.MedStar Washington Hospital CenterWashingtonUSA

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