Home Blood Pressure Monitoring by Unknown

Author:Unknown
Language: eng
Format: epub
ISBN: 9783030230654
Publisher: Springer International Publishing

9.4.1 Data from Randomized Controlled Trials

A randomized trial conducted in the Kaiser Permanente Medical System evaluated the cost of HBPM versus usual care among 430 patients who were randomized at a 1:1 ratio to a HBPM intervention or usual care [23]. The intervention included receipt of a HBPM device with the request to measure BP twice weekly and mail a record of the recordings along with changes in medications/side effects every 4 weeks. After a 1-year intervention period, the decline in SBP and DBP were 3.3 mm Hg and 1.6 mm Hg larger among participants randomized to the HBPM intervention compared with usual care. Participants randomized to the HBPM intervention had 1.2 fewer office visits and 0.8 more telephone calls with medical staff compared to their counterparts randomized to usual care. In 1986 US dollars, the cost of hypertension care was lower in the HBPM versus usual care randomization arm ($88.28 versus $125.37). Even considering the cost of the HBPM device and patient training, the authors of this study concluded HBPM to be cost saving.

The cost-effectiveness of HBPM was evaluated in a randomized trial that showed HBPM in conjunction with clinical pharmacist specialist meetings reduced SBP by 21 mm Hg versus 8 mm Hg for those randomized to usual care [24]. Over 6 months of follow-up, the HBPM intervention was associated with hypertension-related costs of $455 per-patient versus $179 per-patient for those randomized to usual care. The higher costs with HBPM resulted from increased contact with healthcare providers, laboratory monitoring, medication use, and the HBPM device. HBPM did not reduce the need for outpatient, hospital or emergency department visits. Total healthcare costs were also higher among participants randomized to the intervention versus usual care ($1530 versus $1283). Extrapolating the BP-lowering of the HBPM intervention across the lifespan, it was associated with a favorable incremental cost-effectiveness ratio (ICER); $20.50 for each 1 mm Hg lowering of SBP and $3330 per additional life-year gained.

Download

Copyright Disclaimer:
This site does not store any files on its server. We only index and link to content provided by other sites. Please contact the content providers to delete copyright contents if any and email us, we'll remove relevant links or contents immediately.