A17995 Value-based assessment of blood pressure telemonitoring in hypertensive patients

Abstract

Objectives: To investigate whether BPTM fits all three principles of value-based approach: clinical benefit, cost-effectiveness and improved patient reported outcome/experience measures (PROMs/PREMs). Methods: Study included 190 ambulatory patients (137 males, mean age 51 ± 17 years) with uncontrolled HTN assigned to BPTM group (110 patients) and usual care group (UC, 80 patients). Both groups had baseline and 3-months follow-up clinic visits. Between visits BPTM patients used simple, secure web-platform allowing physician-patient communication, storage and blood pressure (BP) and medication data exchange. Clinical efficacy endpoints included BP changes and BP target rate. Economic evaluation settled in Euro currency consisted of cost of illness (COI), incremental cost-effectiveness ratio (ICER); cost-utility analysis (CUA) was performed using generic PROM (SF-36). PREMs collection via PEQ chart. Results: BPTM group characterized by significantly larger decrease in BP (−16 ± 6 mmHg SBP,p = 0,005; − 8,4 ± 3,4 mmHg DBP,p = 0,02) while the number of antihypertensive drugs remained unchanged (+0,3 drugs in BPTM group; p = 0,15). COI was x2.36 higher in BPTM (196.9 € vs 83.5 €, p < 0.005) and ICER was 8.45 €/mmHg/patient (95% CI €4,9–12). BPTM improved PROMs (+2.9 for PH-SF-36,p = 0.04) with 0,06 quality adjusted life years (QALYs) gained. Resultant CUA for BPTM was 2698 €/QALY/patient at a willingness-to-pay threshold of 20383 €/QALY. PREMs improved (+10 points,p = 0,01). UC showed minor QoL changes (+1,3 in PH-SF-36,p = 0,56; +6 PEQ, p = 0,03). No association between BP and QoL results (P = 0,5 for all). Conclusion: BPTM being cost-effective and cost-saving tool incorporates both clinical benefits with the patient-perceived value.