Implementation of Single-Pill Combination Therapy Through Team-Based Care for Hypertension Control in Resource-Constrained Settings: A Cluster Randomized Clinical Trial.

Team-based implementation of single-pill combination therapy in 20 primary care clinics in Colombia and Jamaica reduced systolic blood pressure by 10.1 mm Hg more than standard care at 18 months.

• Why it matters: Evidence is limited on how well single-pill regimens work when delivered in routine primary care, especially where resources and implementation support are constrained.
• What they did: In a multicountry, unblinded cluster randomized trial (1706 adults with uncontrolled hypertension), clinics were assigned to team-based care (physician/nurse training, health coaching, home monitoring, audit and feedback) plus locally purchased single-pill combinations versus standard guideline medications.
• The result: From baseline to 18 months, systolic blood pressure fell 19.1 mm Hg with the intervention versus 9.0 mm Hg with standard care (95% CI, -13.3 to -6.9; P < .001), and 69.5% vs 29.2% achieved systolic <130 and diastolic <80 mm Hg, with similar serious adverse event rates (7.9% vs 9.9%).

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