Controlling hypertension immediately post stroke: a cost utility analysis of a pilot randomised controlled trial

Cost Effectiveness and Resource Allocation

Research

Tom Robinson¹  Amit Mistri¹  Edward CF Wilson²  John F Potter²  Carol Jagger³  Gary A Ford⁴ 

[1] Ageing & Stroke Medicine, Department of Cardiovascular Sciences, University of Leicester, Leicester General Hospital, Leicester, UK;Faculty of Health, University of East Anglia, Norwich, UK;Institute for Ageing and Health, Newcastle University, Newcastle Upon Tyne, UK;Stroke Research Group, Institute for Ageing and Health, Newcastle University, UK;

关键词: Incremental Cost;    Antihypertensive Therapy;    Lisinopril;    Labetalol;    Quality Adjust Life Year;   

DOI  :  10.1186/1478-7547-8-3

 received in 2009-09-21, accepted in 2010-03-23,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundElevated blood pressure (BP) levels are common following acute stroke. However, there is considerable uncertainty if and when antihypertensive therapy should be initiated.MethodEconomic evaluation alongside a double-blind randomised placebo-controlled trial (National Research Register Trial Number N0484128008) of 112 hypertensive patients receiving an antihypertensive regimen (labetalol or lisinopril) within 36 hours post stroke versus 59 receiving placebo. Outcomes were incremental cost per incremental: QALY, survivor, and patient free from death or severe disability (modified Rankin scale score < 4) at three months and 14 days post stroke.ResultsActively treated patients on average had superior outcomes and lower costs than controls at three months. From the perspective of the acute hospital setting, there was a 96.5% probability that the incremental cost per QALY gained at three months is below £30,000, although the probability may be overstated due to data limitations.ConclusionAntihypertensive therapy when indicated immediately post stroke may be cost-effective compared with placebo from the acute hospital perspective. Further research is required to confirm both efficacy and cost-effectiveness and establish whether benefits are maintained over a longer time horizon.

【 授权许可】

CC BY   
© Wilson et al; licensee BioMed Central Ltd. 2010