Cost-Effectiveness Analysis of Screening for and Managing Identified Hypertension for Cardiovascular Disease Prevention in Vietnam

Nguyen, TP; Wright, E. Pamela; Nguyen, T; Postma, MJ

doi:10.1016/j.jval.2016.08.395

Cited by 7 publications

(18 citation statements)

References 17 publications

(38 reference statements)

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“…There is no enough evidence to recommend screening asymptomatic adults with no risk factor for hypertension. All studies form developed and developing countries revealed that screening adults aged 40 years with one or more risk factor is cost-effective (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23). This is in line with WHO PEN package interventions for primary health care in developing countries (34).…”

Section: Discussionmentioning

confidence: 74%

“…Concerning the target populations four studies included people aged 40 years and above (13)(14)(15)(16), three studies included people aged 50 years and above (17)(18)(19), two studies included age 30 years and above (20,21) and two studies included age 15 years and above (Table 2) (22,23).…”

Section: Resultsmentioning

confidence: 99%

“…Primary care screening for hypertension, diabetes and protein urea between ages 50 and 69 years followed by ACEI therapy is cost effective (17). Cost-Effectiveness Analysis of Screening for and Managing Identified Hypertension for Cardiovascular Disease Prevention in Vietnam showed that screening at age 55 years and above with or without increase treatment coverage by 20% cost-effective (18). Theses may not be such important in developing countries in which life expectancy is rarely greater than 60 years.…”

Section: Discussionmentioning

confidence: 99%

“…Disease Prevention in Vietnam showed that screening for hypertension resulted in cost saving of $758,695 per QALY gained in ten year horizon. Screening at above 55 years and older with increasing treatment coverage by 20% is cost-effective (18).…”

Section: Cost-effectiveness Analysis Of Screening For and Managing Idmentioning

confidence: 99%

“…Five out of 11 articles determined the cost-effectiveness from payer perspective, 3 studies from societal perspective and 3 from provider perspective. Only three studies are conducted in developing countries Vietnam(18), Nigeria(20) and Kenya(21).…”

mentioning

confidence: 99%

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Cost-effectiveness of Comprehensive screening of general population for hypertension: Can it save money and Life? Systematic review of Pharmacoeconomic Studies

Davari¹,

Sorato²,

Nikfar³

2020

Preprint

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Background: Hypertension is one of major modifiable risk factors contributing for development of ischemic heart disease, diabetes, kidney disease, cerebrovascular disease and peripheral arterial disease. Silent nature of the disease, delayed presentation of patients to health system after development of significant cardiovascular events and poor access to comprehensive health care are major challenge of hypertension control. Early screening, detection and treatment of hypertension is effective for control of the disease progression. However, there is no robust evidence on whether screening general population for hypertension is cost-effective or not. Therefore, this review was conducted t o generate evidence on cost effectiveness of population-based hypertension screening for asymptomatic individuals as early detection strategy for the primary prevention of cardiovascular diseases. Methods: PubMed/Medline , Scopus, Web of sciences and Google Scholar were searched from January 2000 to 11 December 2019. Two investigators independently selected and reviewed fair and good-quality pharmacoeconomic studies for the cost-effectiveness of asymptomatic screening for hypertension in the community. Quality of selected literatures are evaluated by authors based on comprehensive tool developed for critical appraisal of pharmacoeconomic studies. Results: Eleven included Pharmacoeconomic studies reported favorable results for screening asymptomatic adults for hypertension. Most of studies agreed on cost-effectiveness of screening adults aged 40 years and older. Screening of general adult population for hypertension is not-cost effective. Conclusion: Screening population 40 years and older with or without additional risk factors is cost-effective in reducing hypertension and associated cardiovascular disease morbidity and mortality in developed and developing countries.

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Section: Discussionmentioning

confidence: 74%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Cost-effectiveness Analysis Of Screening For and Managing Idmentioning

confidence: 99%

mentioning

confidence: 99%

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Cost-effectiveness of Comprehensive screening of general population for hypertension: Can it save money and Life? Systematic review of Pharmacoeconomic Studies

Davari¹,

Sorato²,

Nikfar³

2020

Preprint

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Provider perceptions of hypertension care in a low‐resource setting

Spies

Anh

2020

Int J of Nursing Practice

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Aim Globally, the rapid increase of hypertension is particularly prevalent in low‐ and middle‐income countries. Hypertension is the most significant modifiable risk factor for stroke and ischaemic heart disease, the leading cause of mortality in Vietnam. The aim of this study was to gain insight into the provision of hypertension care in Vietnam by exploring provider perceptions. Methods A sequential exploratory mixed‐method design was selected to allow for the initial qualitative interview findings to be incorporated into the development of the hypertension education workshop. Data were collected through semistructured interviews of 15 Vietnamese clinicians involved in the care of patients with hypertension. Results Anxiety related to diagnosis of hypertension and specifically fear of having a stroke was mentioned by half of the participants. Several themes also emerged regarding barriers to implementing lifestyle modification to improve patient hypertension outcomes. There were contradictory opinions on the nurse's role in providing patient education across clinical settings. A lack of systematic structure and evidence‐based teaching resources was also noted. Conclusions Gaining the provider's perspective increases understanding of the regional culture and context of hypertension care. The increased understanding can be used to improve provider education and enhance hypertension population outcomes.

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The cost-effectiveness of government actions to reduce sodium intake through salt substitutes in Vietnam

Taylor¹,

Hoek²,

Deltetto

et al. 2020

Preprint

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BackgroundDietary sodium reduction is recommended to reduce the burden of cardiovascular disease. In Vietnam food products including salt, fish sauce and bot canh contribute to ~70% of dietary sodium intake. Reduced sodium versions of these products can be produced by replacing some of the sodium chloride with potassium chloride. We aimed to assess the cost-effectiveness of three alternative approaches to introducing reduced sodium products onto the market with a view to lowering population sodium intake in Vietnam.MethodsThe three salt substitution strategies included voluntary, subsidised and regulatory approaches targeting salt, fish sauce and bot canh products. Costs were modelled using the WHO-CHOICE methodology. A Markov cohort model was developed to evaluate the cost-effectiveness of each strategy versus no intervention from the government perspective. The model linked each intervention strategy to assumed changes in levels of sodium intake and then to systolic blood pressure. Changes in SBP were linked to a probability of ischaemic heart disease or stroke. The model followed people over their lifetime to assess average costs and quality adjusted life years (QALYs) gained for each strategy. Results The voluntary salt substitution strategy was assumed to require no investment by government. Following ramp up (years 6+), the average annual costs for the subsidised and regulatory strategies were 21,808,968,902 ₫ (US$ 977,354) and 12,949,953,247 ₫ (US$ 580,410) respectively. Relative to no intervention, all three salt substitution strategies were found to be cost-effective. Cost savings were driven by reductions in strokes (32,595; 768,384; 2,366,480) and ischaemic heart disease (IHD) events (22,830; 537,157; 1,648,590) for the voluntary, subsidised & regulatory strategies, respectively. The voluntary strategy was least cost-effective (-3,445 ₫ US$ -0.15; 0.009 QALYs gained) followed by the subsidised strategy (-43,189 ₫ US$ -1.86; 0.022 QALYs gained) and the regulatory strategy delivered the highest cost savings and health gains (-243,530 ₫ US$ -10.49; 0.074 QALYs gained). ConclusionThis research shows that all three modelled salt substitution strategies would be good value for money relative to no intervention in Vietnam. The subsidised alternative would require the highest level of government investment, however the implementation costs will be exceeded by healthcare savings assuming a reasonable time horizon is considered.

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Cost-Effectiveness Analysis of Screening for and Managing Identified Hypertension for Cardiovascular Disease Prevention in Vietnam

Cited by 7 publications

References 17 publications

Cost-effectiveness of Comprehensive screening of general population for hypertension: Can it save money and Life? Systematic review of Pharmacoeconomic Studies

Cost-effectiveness of Comprehensive screening of general population for hypertension: Can it save money and Life? Systematic review of Pharmacoeconomic Studies

Provider perceptions of hypertension care in a low‐resource setting

The cost-effectiveness of government actions to reduce sodium intake through salt substitutes in Vietnam

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