• Am J Prev Med · Dec 2017

    Review

    A Systematic Review of Economic Evidence on Community Hypertension Interventions.

    • Donglan Zhang, Guijing Wang, and Heesoo Joo.
    • Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, Georgia. Electronic address: dzhang@uga.edu.
    • Am J Prev Med. 2017 Dec 1; 53 (6S2): S121S130S121-S130.

    ContextEffective community-based interventions are available to control hypertension. It is important to determine the economics of these interventions.Evidence AcquisitionPeer-reviewed studies from January 1995 through December 2015 were screened. Interventions were categorized into educational interventions, self-monitoring interventions, and screening interventions. Incremental cost-effectiveness ratios were summarized by types of interventions. The review was conducted in 2016.Evidence SynthesisThirty-four articles were included in the review (16 from the U.S., 18 from other countries), including 25 on educational interventions, three on self-monitoring interventions, and six on screening interventions. In the U.S., five (31.3%) studies on educational interventions were cost saving. Among the studies that found the interventions cost effective, the median incremental costs were $62 (range, $40-$114) for 1-mmHg reduction in systolic blood pressure (SBP) and $13,986 (range, $6,683-$58,610) for 1 life-year gained. Outside the U.S., educational interventions cost from $0.62 (China) to $29 (Pakistan) for 1-mmHg reduction in SBP. Self-monitoring interventions, evaluated in the U.S. only, cost $727 for 1-mmHg reduction in SBP and $41,927 for 1 life-year gained. For 1 quality-adjusted life-year, screening interventions cost from $21,734 to $56,750 in the U.S., $613 to $5,637 in Australia, and $7,000 to $18,000 in China. Intervention costs to reduce 1 mmHg blood pressure or 1 quality-adjusted life-year were higher in the U.S. than in other countries.ConclusionsMost studies found that the three types of interventions were either cost effective or cost saving. Quality of economic studies should be improved to confirm the findings.Copyright © 2017 American Journal of Preventive Medicine. All rights reserved.

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