Comparative Cost-Effectiveness of Clinic, Home, or Ambulatory Blood Pressure Measurement for Hypertension Diagnosis in US Adults
| Autor: | Anthony J. Viera, Hadi Beyhaghi |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Pediatrics
medicine.medical_specialty Ambulatory blood pressure business.industry Cost effectiveness White coat hypertension 030204 cardiovascular system & hematology medicine.disease 03 medical and health sciences Masked Hypertension 0302 clinical medicine Blood pressure Ambulatory blood pressure measurement Health care Internal Medicine medicine 030212 general & internal medicine Hypertension diagnosis business |
| Zdroj: | Hypertension. 73:121-131 |
| ISSN: | 1524-4563 0194-911X |
| DOI: | 10.1161/hypertensionaha.118.11715 |
| Popis: | Previous cost-effectiveness models found ambulatory blood pressure monitoring (ABPM) to be a favorable strategy to diagnose hypertension; however, they mostly focused on older adults with a positive clinic blood pressure (BP) screen. We evaluated the cost-effectiveness of 3 methods of BP measurement for hypertension diagnosis in primary care settings among 14 age- and sex-stratified hypothetical cohorts (adults ≥21 years of age), accounting for the possibility of both false-positive (white-coat hypertension) and false-negative (masked hypertension) clinic measurements. We compared quality-adjusted life-years and lifetime costs ($US 2017 from the US healthcare perspective) associated with clinic BP measurement, home BP monitoring, and ABPM under 2 scenarios: positive and negative initial screen. Model parameters were obtained from published literature, publicly available data sources, and expert input. In the screen-positive scenario, ABPM was the dominant strategy among all age and sex groups. Compared with clinic BP measurement, ABPM was associated with cost-savings ranging from $77 (women 80 years of age) to $5013 (women 21 years of age). In the screen-negative scenario, ABPM was the dominant strategy in all men and women |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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