Success factors in high-effect, low-cost eHealth programs for patients with hypertension: a systematic review and meta-analysis.
Eur J Prev Cardiol
; 28(14): 1579-1587, 2021 12 20.
Article
em En
| MEDLINE
| ID: mdl-34929044
ABSTRACT
BACKGROUND:
eHealth programs can lower blood pressure but also drive healthcare costs. This study aims to review the evidence on the effectiveness and costs of eHealth for hypertension and assess commonalities in programs with high effect and low additional cost.RESULTS:
Overall, the incremental decrease in systolic blood pressure using eHealth, compared to usual care, was 3.87 (95% confidence interval (CI) 2.98-4.77) mmHg at 6 months and 5.68 (95% CI 4.77-6.59) mmHg at 12 months' follow-up. High intensity interventions were more effective, resulting in a 2.6 (95% CI 0.5-4.7) (at 6 months) and 3.3 (95% CI 1.4-5.1) (at 12 months) lower systolic blood pressure, but were also more costly, resulting in 170 (95% CI 56-284) higher costs at 6 months and 342 (95% CI 128-556) at 12 months. Programs that included a high volume of participants showed 203 (95% CI 99-307) less costs than those with a low volume at 6 months, and 525 (95% CI 299-751) at 12 months without showing a difference in systolic blood pressure. Studies that implemented eHealth as a partial replacement, rather than addition to usual care, were also less costly (119 (95% CI -38-201 at 6 months) and 346 (95% CI 261-430 at 12 months)) without being less effective. Evidence on eHealth programs for hypertension is ambiguous, heterogeneity on effectiveness and costs is high (I2 = 56-98%).CONCLUSION:
Effective eHealth with limited additional costs should focus on high intensity interventions, involve a large number of participants and use eHealth as a partial replacement for usual care.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Telemedicina
/
Hipertensão
Tipo de estudo:
Diagnostic_studies
/
Health_economic_evaluation
/
Systematic_reviews
Limite:
Humans
Idioma:
En
Revista:
Eur J Prev Cardiol
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Holanda