Evidence mapPaperPMID 39019631Full record

SynthesisBMJ open2024

Effectiveness of team-based care interventions in improving blood pressure outcomes among adults with hypertension in Africa: a systematic review and meta-analysis.

Thomas Hinneh, Hosea Boakye, Faith Metlock, Oluwabunmi Ogungbe, Suratsawadee Kruahong, Samuel Byiringiro, Cheryl Dennison Himmelfarb, Yvonne Commodore-Mensah

Abstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
  7. Article
  8. Expanding team-based care for hypertension and cardiovascular risk management with HEARTS in the Americas.Revista panamericana de salud publica = Pan American journal of public health · 2025
    Article
  9. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Thomas HinnehSchool of Nursing, Johns Hopkins University, Baltimore, Maryland, USA thinneh1@jh.edu.ORCID 0000-0002-4417-506X
Hosea BoakyeSargent College of Health and Rehabilitation Sciences, Boston University, Boston, Massachusetts, USA.ORCID 0000-0003-4917-5146
Faith MetlockSchool of Nursing, Johns Hopkins University, Baltimore, Maryland, USA.
Oluwabunmi OgungbeSchool of Nursing, Johns Hopkins University, Baltimore, Maryland, USA.ORCID 0000-0003-1813-0906
Suratsawadee KruahongFaculty of Nursing, Department of Nursing, Department of Surgical Nursing, Mahidol University, Bangkok, Thailand.
Samuel ByiringiroSchool of Nursing, Johns Hopkins University, Baltimore, Maryland, USA.
Cheryl Dennison HimmelfarbSchool of Nursing, Johns Hopkins University, Baltimore, Maryland, USA.
Yvonne Commodore-MensahSchool of Nursing, Johns Hopkins University, Baltimore, Maryland, USA.

Funding

Applied Methods for Improving Health Outcomes Across the LifespanT32NR020315 · JOHNS HOPKINS UNIVERSITY · 2025 to 2025
$417k
NINR NIH HHS T32 NR020315
6 · The paper itself

Abstract

objectiveWe evaluated the effectiveness of team-based care interventions in improving blood pressure (BP) outcomes among adults with hypertension in Africa.

designSystematic review and meta-analysis. DATA SOURCE: PubMed, CINAHL, EMBASE, Cochrane Library, HINARI and African Index Medicus databases were searched from inception to March 2023. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: We included randomised controlled trials (RCTs) and pre-post study designs published in English language focusing on (1) Adults diagnosed with hypertension, (2) Team-based care hypertension interventions led by non-physician healthcare providers (HCPs) and (3) Studies conducted in Africa. DATA EXTRACTION AND SYNTHESIS: We extracted study characteristics, the nature of team-based care interventions, team members involved and other reported secondary outcomes. Risk of bias was assessed using the Cochrane Risk of Bias tool for RCTs and the National Heart, Lung, and Blood Institute assessment tool for pre-post studies. Findings were summarised and presented narratively including data from pre-post studies. Meta-analysis was conducted using a random effects model for only RCT studies. Overall certainty of evidence was determined using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) tool for only the primary outcome (systolic BP).

resultsOf the 3375 records screened, 33 studies (16 RCTs and 17 pre-post studies) were included and 11 RCTs were in the meta-analysis. The overall mean effect of team-based care interventions on systolic BP reduction was -3.91 mm Hg (95% CI -5.68 to -2.15, I² = 0.0%). Systolic BP reduction in team-based care interventions involving community health workers was -4.43 mm Hg (95% CI -5.69 to -3.17, I² = 0.00%) and nurses -3.75 mm Hg (95% CI -10.62 to 3.12, I² = 42.0%). Based on the GRADE assessment, we judged the overall certainty of evidence low for systolic BP reduction suggesting that team-based care intervention may result in a small reduction in systolic BP.

conclusionEvidence from this review supports the implementation of team-based care interventions across the continuum of care to improve awareness, prevention, diagnosis, treatment and control of hypertension in Africa.

Indexed as

Blood PressureHypertensionPatient Care TeamAdultAfricaHumansRandomized Controlled Trials as Topichypertensionmeta-analysissystematic review

Identifiers

PMID39019631
PMCPMC11284891

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.