Practical application of the ATOM study

Paz, Marco A.; Farrerons, Mònica; Sáez, Marc; Saurina, Carme; Pinto, Marc Garcia; Castro, Sonia; Sobrino, Javier; Tuero, Gabriel Coll de

doi:10.1097/md.0000000000015010

Cited by 2 publications

(2 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Changing to the HEARTS ACE-I or ARB + diuretic protocol in which all patients are on at least two medications increases the cost of treating patients, but combination therapy has been demonstrated to significantly increase rates of hypertension control with few adverse side effects compared to monotherapy (26)(27)(28)(29)(30). Future analyses examining the cost-effectiveness of treatment regimens could lend insight into how much health benefit is purchased for the additional cost (21), providing decision makers with information that could be used to inform national pharmacological treatment guidelines.…”

Section: Discussionmentioning

confidence: 99%

“…The scenario applies the same per unit medication costs reported within the survey instrument, but if a different medication strength was specified in the protocols than had been reported in the survey instrument (e.g., amlodipine 10 mg instead of 5 mg), medication cost is increased by 50% following published assumptions (20). To determine the percent of patients with a given risk factor who receive low-medium-and high-intensity treatment regimens, we drew on risk-factorseverity distribution data (e.g., for those with hypertension, the percent with systolic blood pressure levels 140 to <150 mmHg, 150 to <160 mmHg, or >160 mmHg) from Mexico's 2018 National Health and Nutrition Survey (ENSANUT) and mapped it against pharmacological regimen intensity recommendations from published literature or protocols (19,21,22).…”

Section: Costing Framework By Hearts Componentmentioning

confidence: 99%

See 1 more Smart Citation

Assessing costs of a hypertension program in primary care: evidence from the HEARTS program in Mexico

Chivardi

Hutchinson

Molina

et al. 2022

Revista Panamericana De Salud Pública

View full text Add to dashboard Cite

Objective. In 2021, Mexico launched the HEARTS program to improve the prevention and control of cardiovascular disease (CVD) risk factors in 20 primary care facilities in the states of Chiapas and Yucatán. This study projects the annual cost of program implementation and discusses budgetary implications for scaling up the program. Methods. We obtained district-level data on treatment protocols, medication costs, and other resources required to prevent and treat CVD. We used the HEARTS Costing Tool to estimate total and per-patient costs. A “partial implementation” scenario calculated the costs of implementing HEARTS if existing pharmacological treatment protocols are left in place. The second scenario, “full implementation,” examined costs if programs use HEARTS pharmacological protocol. Results. Respectively in the partial and full implementation scenarios, total annual costs to implement and operate HEARTS were $260 023 ($32.1 per patient/year) and $255 046 ($31.5 per patient/year) in Chiapas, and $1 000 059 ($41.3 per patient/year) and $1 013 835 ($43.3 per patient/year) in Yucatán. In Chiapas, adopting HEARTS standardized treatment protocols resulted in a 9.7 % reduction in annual medication expenditures relative to maintaining status-quo treatment approaches. In Yucatán, adoption was $12 875 more expensive, in part because HEARTS hypertension treatment regimens were more intensive than status quo regimens. Conclusion. HEARTS in the Americas offers a standardized strategy to treating and controlling CVD risk factors. In Mexico, approaches that may lead to improved program affordability include adoption of the recommended HEARTS treatment protocols with preferred medications and task shifting of services from physicians to nurses and other providers.

show abstract