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Economic evaluation of telephone self-management interventions for blood pressure control.

Abstract：

BACKGROUND:Half of patients with hypertension have poor blood pressure (BP) control. Recent models for treating hypertension have integrated disease monitoring and telephone-based interventions delivered in patients' homes. This study evaluated the costs of the Hypertension Intervention Nurse Telemedicine Study (HINTS), aimed to improve BP control in veterans. METHODS:Eligible veterans were randomized to either usual care or 1 of 3 telephone-based intervention groups using home BP telemonitoring: (1) behavioral management, (2) medication management, or (3) combined. Intervention costs were derived from information collected during the trial. Direct medical costs (inpatient, outpatient, and outpatient pharmacy, including hypertension-specific pharmacy) at 18 months by group were calculated using Veterans Affairs (VA) Decision Support System data. Bootstrapped CIs were computed to compare intervention and medical costs between intervention groups and usual care. RESULTS:Patients receiving behavior or medication management showed significant gains in BP control at 12 months; there were no differences in BP control at 18 months. In subgroup analysis, patients with poor baseline BP control receiving combined intervention significantly improved BP at 12 and 18 months. In overall and subgroup samples, average intervention costs were similar in the 3 study arms, and at 18 months, there were no statistically significant differences in direct VA medical costs or total VA costs between treatment arms and usual care. CONCLUSIONS:To optimize investment in telephone-based home interventions such as the HINTS, it is important to identify groups of patients who are most likely to benefit from more intensive home BP management.

journal_name

Am Heart J

journal_title

American heart journal

authors

Wang V,Smith VA,Bosworth HB,Oddone EZ,Olsen MK,McCant F,Powers BJ,Van Houtven CH

doi

10.1016/j.ahj.2012.03.016

subject

Has Abstract

pub_date

2012-06-01 00:00:00

pages

980-6

issue

6

eissn

0002-8703

issn

1097-6744

pii

S0002-8703(12)00182-2

journal_volume

163

pub_type

杂志文章,随机对照试验

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