Yearly hypertension screening in women with a history of pre-eclampsia: a cost-effectiveness analysis
Yearly hypertension screening in women with a history of pre-eclampsia: a cost-effectiveness analysis
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DOI：
10.1007/s12471-015-0760-z
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发表时间：
2015-12-01
影响因子：
2
通讯作者：
Maas, A. H. E. M.
中科院分区：
文献类型：
--
作者：
Drost, J. T.;Grutters, J. P. C.;Maas, A. H. E. M.
背景 有先兆子痫病史的女性未来患高血压和心血管疾病 (CVD) 的风险增加；到目前为止，尚不清楚是否需要采取预防措施。方法根据现有文献，构建决策分析马尔可夫模型来评估子痫前期高血压的医疗保健成本以及筛查和治疗（100％依从性）的效果。心血管事件和CVD死亡率被定义为健康状况。结果以绝对成本、事件、生命年和质量调整生命年（QALY）来衡量。进行敏感性和阈值分析以解决不确定性。结果 在 20 年的时间范围内，筛查后 7.2% 的人群中发生了事件，未筛查的人群中 8.5% 的人群中发生了事件。 QALY 从 16.37（无筛查策略）增加至 16.40（筛查策略），增量为 0.03（95% CI 0.01；0.05）QALY。筛查策略中的预计总成本为（原文如此）8016，无筛查策略中的（原文如此）9087（预计每人节省（原文如此）1071（95% CI -3146；-87））。结论 对于有先兆子痫病史的女性，每年进行高血压筛查和治疗可节省成本，与标准护理相比，预防 CVD 至少可带来相似的生活质量和生存率。
Background Women with a history of preeclampsia are at increased risk for future hypertension and cardiovascular disease (CVD); until now it is not clear whether preventive measures are needed.Methods A decision-analytic Markov model was constructed to evaluate healthcare costs and effects of screening and treatment (100 % compliance) for hypertension post preeclampsia based on the available literature. Cardiovascular events and CVD mortality were defined as health states. Outcomes were measured in absolute costs, events, life-years and quality-adjusted life-years (QALYs). Sensitivity and threshold analyses were performed to address uncertainty.Results Over a 20-year time horizon, events occurred in 7.2 % of the population after screening, and in 8.5 % of the population without screening. QALYs increased from 16.37 (no screening strategy) to 16.40 (screening strategy), an increment of 0.03 (95 % CI 0.01; 0.05) QALYs. Total expected costs were (sic) 8016 in the screening strategy, and (sic) 9087 in the none screening strategy (expected saving of (sic) 1071 (95 % CI -3146;-87) per person).Conclusion Annual hypertension screening and treatment in women with a history of preeclampsia may save costs, for at least a similar quality of life and survival due to prevented CVD compared with standard care.