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Author Notes:

Correspondence: Verughese Jacob, PhD, MPH, Community Guide Branch, CDC, 1600 Clifton Road, Mailstop E69, Atlanta GA 30329. hir0@cdc.gov.

Acknowledgments: This authors acknowledge the Division for Heart Disease and Stroke Prevention, Center for Disease Control and Prevention (CDC), for support and subject matter expertise.

We thank members of our coordination team in the Community Guide Branch at CDC and from other areas of CDC, and our external partners.

The authors also thank Randy W. Elder, PhD and Kate W. Harris, BA from the Community Guide Branch, and Onnalee Gomez, MS from the Library Services Branch, at CDC for their assistance throughout the review.

Disclosures: No financial disclosures were reported by the authors of this paper.

Subjects:

Research Funding:

The work of Jeffrey Reynolds was supported with funds from the Oak Ridge Institute for Science and Education.

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Public, Environmental & Occupational Health
  • Medicine, General & Internal
  • General & Internal Medicine
  • COST-EFFECTIVENESS EVALUATION
  • TELEMEDICINE CASE-MANAGEMENT
  • RANDOMIZED-CONTROLLED-TRIAL
  • AMERICAN-HEART-ASSOCIATION
  • TASK-FORCE RECOMMENDATION
  • USUAL CARE
  • HYPERTENSION CONTROL
  • STROKE ASSOCIATION
  • AFRICAN-AMERICANS
  • DIABETES-MELLITUS

Economics of Self-Measured Blood Pressure Monitoring: A Community Guide Systematic Review

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Journal Title:

American Journal of Preventive Medicine

Volume:

Volume 53, Number 3

Publisher:

, Pages E105-E113

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Context The health and economic burden of hypertension, a major risk factor for cardiovascular disease, is substantial. This systematic review evaluated the economic evidence of self-measured blood pressure (SMBP) monitoring interventions to control hypertension. Evidence acquisition The literature search from database inception to March 2015 identified 22 studies for inclusion with three types of interventions: SMBP used alone, SMBP with additional support, and SMBP within team-based care (TBC). Two formulae were used to convert reductions in systolic BP (SBP) to quality-adjusted life years (QALYs) to produce cost per QALY saved. All analyses were conducted in 2015, with estimates adjusted to 2014 U.S. dollars. Evidence synthesis Median costs of intervention were $60 and $174 per person for SMBP alone and SMBP with additional support, respectively, and $732 per person per year for SMBP within TBC. SMBP alone and SMBP with additional support reduced healthcare cost per person per year from outpatient visits and medication (medians $148 and $3, respectively; median follow-up, 12–13 months). SMBP within TBC exhibited an increase in healthcare cost (median, $369 per person per year; median follow-up, 18 months). SMBP alone varied from cost saving to a maximum cost of $144,000 per QALY saved, with two studies reporting an increase in SBP. The two translated median costs per QALY saved were $2,800 and $4,000 for SMBP with additional support and $7,500 and $10,800 for SMBP within TBC. Conclusions SMBP monitoring interventions with additional support or within TBC are cost effective. Cost effectiveness of SMBP used alone could not be determined.

Copyright information:

© 2018 Elsevier Inc.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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