Topics

Comparative Cost-Effectiveness of Clinic, Home, or Ambulatory Blood Pressure Measurement for Hypertension Diagnosis in US Adults.

07:00 EST 1st January 2019 | BioPortfolio

Summary of "Comparative Cost-Effectiveness of Clinic, Home, or Ambulatory Blood Pressure Measurement for Hypertension Diagnosis in US Adults."

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 <80 years of age with cost-savings ranging from $128 (women 70 years of age) to $2794 (women 21 years of age). Sensitivity analyses showed that results were sensitive to test specificity and antihypertensive medication costs. ABPM is recommended as the diagnostic strategy of choice for most adults in primary care settings regardless of initial screening results.

Affiliation

Journal Details

This article was published in the following journal.

Name: Hypertension (Dallas, Tex. : 1979)
ISSN: 1524-4563
Pages: 121-131

Links

DeepDyve research library

PubMed Articles [18912 Associated PubMed Articles listed on BioPortfolio]

Blood pressure checks and diagnosing hypertension (BP-CHECK): Design and methods of a randomized controlled diagnostic study comparing clinic, home, kiosk, and 24-hour ambulatory BP monitoring.

The US Preventive Services Task Force recommends out-of-office blood pressure (BPs) before making a new diagnosis of hypertension, using 24-h ambulatory (ABPM) or home BP monitoring (HBPM), however th...

Does the duration of ambulatory blood pressure measurement matter in diagnosing arterial hypertension in children?

The aim of our study was to establish if 48-hour ambulatory blood pressure monitoring (ABPM) is more reliable than 24-hour monitoring in order to reduce the impact of external factors on blood pressur...

Agreement between ambulatory and home blood pressure monitoring in detecting night-time hypertension and nondipping patterns in the general population.

Night-time blood pressure (BP) and nondipping pattern are strongly associated with hypertensive end-organ damage. However, no previous studies have compared the diagnostic agreement between ambulatory...

Sex differences in masked hypertension: the Coronary Artery Risk Development in Young Adults study.

To evaluate the association of sex with masked hypertension, defined by out-of-clinic hypertension based on ambulatory blood pressure monitoring (ABPM) among adults without hypertension based on blood...

A comparative meta-analysis of prospective observational studies on masked hypertension and masked uncontrolled hypertension defined by ambulatory and home blood pressure.

In a comparative meta-analysis, we investigated the prognostic value of masked hypertension and masked uncontrolled hypertension defined by ambulatory or home blood pressure (BP) monitoring.

Clinical Trials [18481 Associated Clinical Trials listed on BioPortfolio]

The Effect of Home Blood Pressure Measurement on the Management of Hypertension

Home blood pressure measurement has been reported to be associated with better clinic blood pressure and daytime blood pressure control. However, no study has evaluated the association bet...

Ambulatory Versus Home Blood Pressure Measurement

This is a prospective study comparing the three blood pressure monitoring methods on the diagnosis of arterial hypertension. Blood pressure of each subject will be evaluated with clinic, h...

Home Blood Pressure in Hypertension Management

This is a prospective randomized study with two arms: the Conventional and Ambulatory blood pressure monitoring arm and the Home blood pressure monitoring arm. The study will include both ...

Diagnosis of Hypertension by Home Blood Pressure Monitoring

Home blood pressure measurement has been recommended to use in the diagnosis of hypertension. We developed diagnostic algorithm of hypertension by using 24-hour and home blood pressure mea...

Using Health Information Technology (HIT) to Improve Ambulatory Chronic Disease Care: Smart Device Substudy

In-home health monitoring devices have the potential to increase the speed and ease of modifying treatment for ambulatory patients living with chronic conditions. This study examines the i...

Medical and Biotech [MESH] Definitions

Method in which repeated blood pressure readings are made while the patient undergoes normal daily activities. It allows quantitative analysis of the high blood pressure load over time, can help distinguish between types of HYPERTENSION, and can assess the effectiveness of antihypertensive therapy.

A method of comparing the cost of a program with its expected benefits in dollars (or other currency). The benefit-to-cost ratio is a measure of total return expected per unit of money spent. This analysis generally excludes consideration of factors that are not measured ultimately in economic terms. Cost effectiveness compares alternative ways to achieve a specific set of results.

Phenomenon where increased BLOOD PRESSURE readings taken in non-clinical settings (e.g., HOME BLOOD PRESSURE MONITORING) do not replicate in clinical settings.

Persons who receive ambulatory care at an outpatient department or clinic without room and board being provided.

Persistently high systemic arterial BLOOD PRESSURE. Based on multiple readings (BLOOD PRESSURE DETERMINATION), hypertension is currently defined as when SYSTOLIC PRESSURE is consistently greater than 140 mm Hg or when DIASTOLIC PRESSURE is consistently 90 mm Hg or more.

Quick Search


DeepDyve research library

Searches Linking to this Article