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Telemonitoring and self-management in the control of hypertension (TASMINH2): a cost-effectiveness analysis.

Abstract：

AIMS:Self-monitoring and self-titration of antihypertensives (self-management) is a novel intervention which improves blood pressure control. However, little evidence exists regarding the cost-effectiveness of self-monitoring of blood pressure in general and self-management in particular. This study aimed to evaluate whether self-management of hypertension was cost-effective. DESIGN AND METHODS:A cohort Markov model-based probabilistic cost-effectiveness analysis was undertaken extrapolating to up to 35 years from cost and outcome data collected from the telemonitoring and self-management in hypertension trial (TASMINH2). Self-management of hypertension was compared with usual care in terms of lifetime costs, quality adjusted life years and cost-effectiveness using a UK Health Service perspective. Sensitivity analyses examined the effect of different time horizons and reduced effectiveness over time from self-management. RESULTS:In the long-term, when compared with usual care, self-management was more effective by 0.24 and 0.12 quality adjusted life years (QALYs) gained per patient for men and women, respectively. The resultant incremental cost-effectiveness ratio for self-management was £1624 per QALY for men and £4923 per QALY for women. There was at least a 99% chance of the intervention being cost-effective for both sexes at a willingness to pay threshold of £20,000 per QALY gained. These results were robust to sensitivity analyses around the assumptions made, provided that the effects of self-management lasted at least two years for men and five years for women. CONCLUSION:Self-monitoring with self-titration of antihypertensives and telemonitoring of blood pressure measurements not only reduces blood pressure, compared with usual care, but also represents a cost-effective use of health care resources.

journal_name

Eur J Prev Cardiol

journal_title

European journal of preventive cardiology

authors

Kaambwa B,Bryan S,Jowett S,Mant J,Bray EP,Hobbs FD,Holder R,Jones MI,Little P,Williams B,McManus RJ

doi

10.1177/2047487313501886

subject

Has Abstract

pub_date

2014-12-01 00:00:00

pages

1517-30

issue

eissn

2047-4873

issn

2047-4881

pii

2047487313501886

journal_volume

pub_type

杂志文章,多中心研究,随机对照试验

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Telemonitoring and self-management in the control of hypertension (TASMINH2): a cost-effectiveness analysis.