Blood pressure telemonitoring and remote counseling increased quality-adjusted life years (8.31 vs 7.82) and reduced total healthcare costs compared to usual care over a 10-year modeled period.
Does blood pressure telemonitoring and remote counseling improve long-term clinical outcomes and cost-effectiveness in patients with uncontrolled hypertension?
Predictive modeling suggests that blood pressure telemonitoring and remote counseling is a cost-effective strategy that may reduce long-term mortality and healthcare costs in patients with hypertension.
Absolute Event Rate: 8.31% vs 7.82%
Telehealth is a useful adjunct in hypertension (HTN) management. Despite obvious short-term clinical benefit, long-term social impact and cost-effectiveness have not been fully investigated. AIM: Predictive modeling of long-term clinical and social outcomes and the cost-effectiveness analysis of blood pressure (BP) telemonitoring and remote counseling (BPTM) in patients with HTN. MATERIALS AND METHODS: A Markov cohort-based (1000 patients in each study arm) model was developed and adopted a 10-year time horizon with 12-month time cycles. Cost and outcome data collected from the three-month study of 240 patients (160 in BPTM group and 80 controls, 48 y.o.). All patients started at a non-complicated HTN well state with a certain possibility of disease progression in a number of health states over a discrete time period. BPTM was compared with usual care in terms of 10-year healthcare costs, quality adjusted life years (QALY) using a Ministry of Health of Russian Federation perspective. RESULTS: In the long-term run when compared with usual care BPTM was more effective in terms mortality (67 versus 91 patients lost and 9.6 versus 9.71 life years gained) and costs (cost of illness 102 508 000 RUR versus 145 237 700 RUR). Taking quality of life measures into account, the effect of BPTM was also more pronounced (8.31 versus 7.82 QALYs gained). The resultant incremental cost-utility ratio for BPTM was 275 178.98 RUR/1 QALY gained/1 patient (134 837.70 RUR/0.49 QALY/1 patient). CONCLUSION: According to the results of predictive modeling, implementation of BPTM into clinical practice is likely lead to reduced cardiovascular morbidity and mortality in a cost-effective way.
Ionov et al. (Sun,) conducted a other in Uncontrolled hypertension (n=240). Blood pressure telemonitoring and remote counseling vs. Usual care was evaluated on Quality-adjusted life years (QALY) over 10 years. Blood pressure telemonitoring and remote counseling increased quality-adjusted life years (8.31 vs 7.82) and reduced total healthcare costs compared to usual care over a 10-year modeled period.
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