Cost Effectiveness of Ambulatory Blood Pressure Monitoring Compared with Home or Clinic Blood Pressure Monitoring for Diagnosing Hypertension in Australia

Shah, Karan; Willson, Melina L; Agresta, Blaise; Morton, Rachael L.

doi:10.1007/s41669-022-00364-0

Cited by 6 publications

(30 citation statements)

References 25 publications

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“…6,13,15,16,20,21,23,24,[26][27][28]30 Differential timing was taken into account in all of the studies. 6,[13][14][15][16]20,21,[23][24][25][26][27][28][29][30][31] An incremental analysis of costs and outcomes was conducted in 15 studies (94%). 6,[13][14][15]20,21,[23][24][25][26][27][28][29][30][31] A sensitivity analysis was conducted in 15 studies (94%).…”

Section: Study Quality Assessment Criteriamentioning

confidence: 99%

“…6,[13][14][15][16]20,21,[23][24][25][26][27][28][29][30][31] An incremental analysis of costs and outcomes was conducted in 15 studies (94%). 6,[13][14][15]20,21,[23][24][25][26][27][28][29][30][31] A sensitivity analysis was conducted in 15 studies (94%). 6,[13][14][15][16]20,21,[23][24][25][26][27][28][29][30] The majority of the studies provided a comprehensive assessment of the costeffectiveness of the intervention over the control.…”

Section: Study Quality Assessment Criteriamentioning

confidence: 99%

“…Of 16 studies, 7 were trials, 6,14,16,20,21,25,29 1 was a quasi-experimental study, 31 and 8 were simulation models, of which 7 were Markov models 13,15,23,24,26,28,30 and 1 was a microsimulation model. 27 All…”

Section: Main Study Characteristicsmentioning

confidence: 99%

“…The health outcome measures differed across studies and included cost per QALY in 8 studies, 13,15,23,24,26,27,30,31 cost per life-year saved in 3 studies, 15,16,25 cost per 1-mm Hg reduction in BP in 7 studies, 6,14,20,21,24,25,29 cost per improved BP control in 3 studies, 14,20,25 and cost per qualityadjusted days (QADs) in 1 study. 28 In 9 studies (4 of which were conducted in the UK, 13,23,26,30 2 in the US, 27,28 and the rest in Russia, 24 Australia, 15 and Singapore 31 ), a willingness to pay threshold (WTP) to determine whether an intervention was cost-effective was mentioned. A sensitivity analysis was conducted in 15 studies (94%) 6,[13][14][15][16]20,21,[23][24][25][26][27][28][29][30] (Table 3).…”

Section: Cost-effectiveness Outcomes Outcome Measurementioning

confidence: 99%

“…28 In 9 studies (4 of which were conducted in the UK, 13,23,26,30 2 in the US, 27,28 and the rest in Russia, 24 Australia, 15 and Singapore 31 ), a willingness to pay threshold (WTP) to determine whether an intervention was cost-effective was mentioned. A sensitivity analysis was conducted in 15 studies (94%) 6,[13][14][15][16]20,21,[23][24][25][26][27][28][29][30] (Table 3).…”

Section: Cost-effectiveness Outcomes Outcome Measurementioning

confidence: 99%

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Economic Evaluation of Blood Pressure Monitoring Techniques in Patients With Hypertension

Hayek,

Giannouchos,

Lawley

et al. 2023

JAMA Netw Open

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ImportanceBlood pressure monitoring is critical to the timely diagnosis and treatment of hypertension. At-home self-monitoring techniques are highly effective in managing high blood pressure; however, evidence regarding the cost-effectiveness of at-home self-monitoring compared with traditional monitoring in clinical settings remains unclear.ObjectiveTo identify and synthesize published research examining the cost-effectiveness of at-home blood pressure self-monitoring relative to monitoring in a clinical setting among patients with hypertension.Evidence ReviewA systematic literature search of 5 databases (PubMed, MEDLINE, Embase, EconLit, and CINAHL) followed by a backward citation search was conducted in September 2022. Full-text, peer-reviewed articles in English including patients with high blood pressure (systolic blood pressure ≥130 mm Hg and diastolic blood pressure ≥80 mm Hg) at baseline were included. Data from studies comparing at-home self-monitoring with clinical-setting monitoring alternatives were extracted, and the outcomes of interest included incremental cost-effectiveness and cost-utility ratios. Non–peer-reviewed studies or studies with pregnant women and children were excluded. To ensure accuracy and reliability, 2 authors independently evaluated all articles for eligibility and extracted relevant data from the selected articles.FindingsOf 1607 articles identified from 5 databases, 16 studies met the inclusion criteria. Most studies were conducted in the US (6 [40%]) and in the UK (6 [40%]), and almost all studies (14 [90%]) used a health care insurance system perspective to determine costs. Nearly half the studies used quality-adjusted life-years gained and cost per 1–mm Hg reduction in blood pressure as outcomes. Overall, at-home blood pressure monitoring (HBPM) was found to be more cost-effective than monitoring in a clinical setting, particularly over a minimum 10-year time horizon. Among studies comparing HBPM alone vs 24-hour ambulatory blood pressure monitoring (ABPM) or HBPM combined with additional support or team-based care, the latter were found to be more cost-effective.Conclusions and RelevanceIn this systematic review, at-home blood pressure self-monitoring, particularly using automatic 24-hour continuous blood pressure measurements or combined with additional support or team-based care, demonstrated the potential to be cost-effective long-term compared with care in the physical clinical setting and could thus be prioritized for patients with hypertension from a cost-effectiveness standpoint.

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Section: Study Quality Assessment Criteriamentioning

confidence: 99%

Section: Study Quality Assessment Criteriamentioning

confidence: 99%

Section: Main Study Characteristicsmentioning

confidence: 99%

Section: Cost-effectiveness Outcomes Outcome Measurementioning

confidence: 99%

Section: Cost-effectiveness Outcomes Outcome Measurementioning

confidence: 99%

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Economic Evaluation of Blood Pressure Monitoring Techniques in Patients With Hypertension

Hayek,

Giannouchos,

Lawley

et al. 2023

JAMA Netw Open

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Cuff-based blood pressure measurement: challenges and solutions

Pilz,

Picone,

Patzak

et al. 2024

Blood Pressure

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Ambulatory and home blood pressure monitoring for cardiovascular disease risk evaluation: a systematic review and meta-analysis of prospective cohort studies

Panagiotakos,

Antza,

Kotsis

2023

Journal of Hypertension

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Objective: The aim of this work was to systematically review the level of evidence based on prospective cohort studies investigating the role of 24-h ambulatory blood pressure measurement (ABPM) and home blood pressure measurement (HBPM) on cardiovascular disease (CVD) risk prediction. Methods: Eight studies were included in the meta-analysis. The Der Simonian and Laird's random-effects model with standard error adjustment using the Knapp-Hartung method was used. Results: SBP from ABPM and HBPM was significantly and positively associated with CVD risk [combined hazard ratio per 1-SD SBP, 95% confidence interval (95% CI): 1.32, 1.19–1.45, I 2 = 35.8%, and 1.30, 95% CI: 1.11–1.49, I 2 = 79.1%, respectively], after adjusting for office BP levels and other potential confounders. DBP from both ABPM and HBPM was positively associated with CVD risk (combined hazard ratio per 1-SD DBP, 95% CI: 1.15, 1.01–1.29, I 2 = 73.1% and 1.21, 1.05–1.37, I 2 = 84.5%, respectively). Conclusion: BP either from ABPM or HBPM could predict CVD risk. As so, at least one of out-of-office BP measurements have to be taken into account during the evaluation of the hypertensive population.

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Cost Effectiveness of Ambulatory Blood Pressure Monitoring Compared with Home or Clinic Blood Pressure Monitoring for Diagnosing Hypertension in Australia

Cited by 6 publications

References 25 publications

Economic Evaluation of Blood Pressure Monitoring Techniques in Patients With Hypertension

Economic Evaluation of Blood Pressure Monitoring Techniques in Patients With Hypertension

Cuff-based blood pressure measurement: challenges and solutions

Ambulatory and home blood pressure monitoring for cardiovascular disease risk evaluation: a systematic review and meta-analysis of prospective cohort studies

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