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Does team-based care improve outcomes for patients with chronic diseases?

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Patients who underwent team-based care interventions had greater SBP control (defined as <140, or <130 in patients with diabetes mellitus or chronic kidney disease) than the control group in trials involving nurses (8 trials; odds ratio [OR]=1.7; 95% confidence interval [CI], 1.5-1.9), trials conducted in community pharmacies (5 trials; OR=2.9; 95% CI, 1.8-4.6), and trials incorporating pharmacists into primary care clinics (9 trials; OR=2.2; 95% CI, 1.8-2.7).

Team-based care improves lipid control

An RCT of 6963 patients with type 2 diabetes mellitus in 9 clinics examined the proportion of patients receiving team-based care that achieved a target low-density lipoprotein (LDL) of ≤100 mg/dL compared with patients receiving usual care.3

Clinics were randomized to participate in team-based care (defined as a physician-pharmacist team in which the pharmacist reviewed the medical charts of patients with elevated LDL and then developed individualized, evidence-based treatment recommendations) or usual care, which involved access to a disease management program providing automated quality reporting, benchmarking, and care opportunity decision support.

Over 2 years, the team-based care model had significantly more patients with a lower LDL, more patients at LDL goal, and more patients on lipid-lowering medication (TABLE3).

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