scholarly journals Cost-effectiveness analysis of population salt reduction interventions to prevent cardiovascular disease in Cameroon: mathematical modelling study

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e041346
Author(s):  
Leopold Ndemnge Aminde ◽  
Linda Cobiac ◽  
J. Lennert Veerman
Keyword(s):  
Cost Effectiveness ◽  
Mass Media ◽  
Sodium Salt ◽  
Education Programme ◽  
School Education ◽  
Salt Reduction ◽  
Low Sodium ◽  
Salt Substitute ◽  
Reduction Strategies ◽  
The Cost

BackgroundReducing dietary sodium (salt) intake has been proposed as a population-wide strategy to reduce blood pressure and cardiovascular disease (CVD). The cost-effectiveness of such strategies has hitherto not been investigated in Cameroon.MethodsA multicohort multistate life table Markov model was used to evaluate the cost-effectiveness of three population salt reduction strategies: mass media campaign, school-based salt education programme and low-sodium salt substitute. A healthcare system perspective was considered and adults alive in 2016 were simulated over the life course. Outcomes were changes in disease incidence, mortality, health-adjusted life years (HALYs), healthcare costs and incremental cost-effectiveness ratios (ICERs) over the lifetime. Probabilistic sensitivity analysis was used to quantify uncertainty.ResultsOver the life span of the cohort of adults alive in Cameroon in 2016, substantial numbers of new CVD events could be prevented, with over 10 000, 79 000 and 84 000 CVD deaths that could be averted from mass media, school education programme and salt substitute interventions, respectively. Population health gains over the lifetime were 46 700 HALYs, 348 800 HALYs and 368 400 HALYs for the mass media, school education programme and salt substitute interventions, respectively. ICERs showed that all interventions were dominant, with probabilities of being cost-saving of 84% for the school education programme, 89% for the mass media campaign and 99% for the low sodium salt substitute. Results were largely robust in sensitivity analysis.ConclusionAll the salt reduction strategies evaluated were highly cost-effective with very high probabilities of being cost-saving. Salt reduction in Cameroon has the potential to save many lives and offers good value for money.

The cost-effectiveness of the KIds in control of food structured education programme for adolescents with type 1 diabetes

2015 ◽  
Author(s):  
Hasan Basirir ◽  
Alan Brennan ◽  
Richard Jacques ◽  
Daniel Pollard ◽  
Katherine Stevens ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Cost Effectiveness ◽  
Education Programme ◽  
Structured Education ◽  
The Cost

scholarly journals Long-Term Effect of Salt Substitute on All-Cause and Cardiovascular Disease Mortality: An Exploratory Follow-Up of a Randomized Controlled Trial

2021 ◽  
Vol 8 ◽  
Author(s):  
Hao Sun ◽  
Bing Ma ◽  
Xiaomei Wu ◽  
Hailong Wang ◽  
Bo Zhou
Keyword(s):  
Randomized Controlled Trial ◽  
Sodium Salt ◽  
Controlled Trial ◽  
Randomized Controlled ◽  
Low Sodium ◽  
Long Term Effect ◽  
Salt Substitute ◽  
Cvd Mortality

Background: Salt substitute, a strategy for salt reduction, has been shown to decrease blood pressure and the incidence of hypertension. However, whether its hypotensive effect will reduce long-term mortality remains unclear. Our study reported an exploratory follow-up of mortality outcomes from previous randomized controlled trial to assess the long-term effect of low-sodium salt on total and cardiovascular disease (CVD) mortality.Methods: Participants who completed a previous 3-year double-blind randomized controlled trial were followed up from 2009 to 2019 to collect mortality data. Multivariable Cox regression models were used to evaluate the association between low-sodium salt intervention and all-cause and CVD mortality.Results: Four hundred and forty participants completed the intervention trial, of which 428 participants had death outcome data recorded after 10 years follow-up: 209 in a salt substitute group and 219 in a normal salt group. Fifty participants died during follow-up, 25 died due to CVD. No significant differences in relative risks were found for all-cause mortality [HR = 0.81, 95% confidence interval (CI): 0.46–1.42] and CVD mortality (HR = 0.58, 95% CI: 0.26–1.32) in unadjusted analyses. After adjusted with age and alcohol drinking status, there were significant reductions for stroke mortality among all participants (HR = 0.26, 95% CI: 0.08–0.84) and for CVD mortality (HR = 0.38, 95% CI: 0.16–0.92) and stroke mortality (HR = 0.25, 95% CI: 0.08–0.82) among hypertensive participants.Conclusions: Compared to normal salt, salt substitute might reduce the risk of CVD death, especially stroke among hypertensive patients. Our exploratory follow-up results provide potential evidence that low-sodium salt may be an accessible and effective strategy for prevention of CVD events, but definitive randomized controlled trials are warranted.

scholarly journals The Salt Content of Lunch Meals Eaten at Danish Worksites

Nutrients ◽  
2018 ◽  
Vol 10 (10) ◽  
pp. 1367 ◽  
Author(s):  
Anne Lassen ◽  
Ellen Trolle ◽  
Anette Bysted ◽  
Pia Knuthsen ◽  
Elisabeth Andersen
Keyword(s):  
Chemical Analysis ◽  
Sodium Salt ◽  
Salt Intake ◽  
Salt Content ◽  
Salt Reduction ◽  
Effective Implementation ◽  
Reduction Strategies ◽  
Duplicate Portion ◽  
Subsequent Chemical

Monitoring levels of sodium (salt) in meals consumed out-of-home is needed to support effective implementation of salt-reduction strategies. The objective of the study was to examine lunch salt intake at 15 worksite canteens and to compare with results from a comparable study conducted 10 years before. A duplicate-portion-technique with subsequent chemical analysis was used to quantify 240 customers’ lunch salt intake. Estimated mean salt intake was 2.6 g/meal (95% Cl: 2.2 to 3.0 g/meal) and 0.78 g/100 g (95% Cl: 0.69 to 0.88 g/100 g). Salt intake measured both as g per meal and per 100 g was found to be significantly higher for male compared with female participants (+0.10 g/100 g, 95% Cl: +0.02 to +0.17 g/100 g, p = 0.011). Compared with the study conducted 10 years before, there was a significantly lower estimated salt intake of 0.5 g/meal (95% CI: −0.8 to −0.2 g/meal, p = 0.001), suggesting a possible reduction in canteen lunch salt intake during a 10-year period. Still, 40% of the meals exceeded the Nordic Keyhole label requirements of maximum 0.8 g salt per 100 g for ready meals. A further reduction of salt intake is warranted to comply with salt reduction targets.

scholarly journals Comparing the cost effectiveness of harm reduction strategies: a case study of the Ukraine

2014 ◽  
Vol 12 (1) ◽  
pp. 25 ◽  
Author(s):  
Sung Kim ◽  
Anni-Maria Pulkki-Brannstrom ◽  
Jolene Skordis-Worrall
Keyword(s):  
Cost Effectiveness ◽  
Harm Reduction ◽  
Reduction Strategies ◽  
The Cost

scholarly journals Compound Ion Salt, a Novel Low-Sodium Salt Substitute: From Animal Study to Community-Based Population Trial

2009 ◽  
Vol 22 (9) ◽  
pp. 934-942 ◽  
Author(s):  
X. Zhou ◽  
J.-X. Liu ◽  
R. Shi ◽  
N. Yang ◽  
D.-L. Song ◽  
...  
Keyword(s):  
Animal Study ◽  
Sodium Salt ◽  
Community Based ◽  
Low Sodium ◽  
Salt Substitute

scholarly journals Cost-Effectiveness of Using Mass Media to Prevent Tobacco Use among Youth and Young Adults: The FinishIt Campaign

2019 ◽  
Vol 16 (22) ◽  
pp. 4312
Author(s):  
Elizabeth C. Hair ◽  
David R. Holtgrave ◽  
Alexa R. Romberg ◽  
Morgane Bennett ◽  
Jessica M. Rath ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Mass Media ◽  
Cost Savings ◽  
Cost Effective ◽  
Cost Utility ◽  
Base Case ◽  
Tobacco Prevention ◽  
Prevention Campaign ◽  
Program Costs ◽  
The Cost

Mass media campaigns have been hailed as some of the most effective tobacco prevention interventions. This study examined the cost-effectiveness of the national tobacco prevention campaign, truth® FinishIt, to determine the cost per quality-adjusted life year (QALY) saved and the return on investment (ROI). The cost–utility analysis used four main parameters: program costs, number of smoking careers averted, treatment costs, and number of QALYs saved whenever a smoking career is averted. Parameters were varied to characterize cost-effectiveness under different assumptions (base case, conservative, optimistic, and most optimistic). The ROI estimate compared campaign expenditures to the cost saved due to the campaign implementation. Analyses were conducted in 2019. The base case analysis indicated the campaign results in a societal cost savings of $3.072 billion. Under the most conservative assumptions, estimates indicated the campaign was highly cost-effective at $1076 per QALY saved. The overall ROI estimate was $174 ($144 in costs to smokers, $24 in costs to the smoker’s family, and $7 in costs to society) in cost savings for every $1 spent on the campaign. In all analyses, the FinishIt campaign was found to reach or exceed the threshold levels of cost savings or cost-effectiveness, with a positive ROI. These findings point to the value of this important investment in the health of the younger generation.

scholarly journals Effect of salt reduction interventions in lowering blood pressure in Chinese populations: a systematic review and meta-analysis of randomised controlled trials

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e032941 ◽  
Author(s):  
Aoming Jin ◽  
Wuxiang Xie ◽  
Yangfeng Wu
Keyword(s):  
Health Education ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Controlled Trials ◽  
High Quality ◽  
Salt Reduction ◽  
Salt Restriction ◽  
Salt Substitute ◽  
Reduction Strategies ◽  
Randomised Controlled

Rationale and objectiveSalt reduction remains a global challenge and different salt reduction strategies have been studied in China. This study is to systematically evaluate evidence from randomised controlled trials (RCT) in China and inform the effective salt reduction strategies.DesignSystematic review and meta-analysis.Data sourcesMEDLINE, Embase, Cochrane Central Register of Controlled Trials, Wanfang Data and the China National Knowledge Infrastructure databases through October 2019.Eligibility criteriaRCTs conducted in China with at least 4 weeks’ duration of study and blood pressure (BP) reported.Data extraction and synthesisData were screened, extracted and appraised by two independent reviewers. The quality of study was assessed using a modified Cochrane Collaboration’s risk of bias tool. The primary outcome was the difference in BP change from baseline to the end of study between interventions and control. The effects were pooled using a random effects model and associated factors were explored by a meta-regression.ResultsWe identified 24 studies involving 10 448 participants, including 8 studies on health education (4583 participants), 2 studies on salt restriction diet (162 participants), 1 study on salt restriction spoon (50 participants) and 13 studies on salt substitute (5653 participants). Six studies on salt substitute and three studies on health education were identified with high quality. Pooled results from the six studies showed that salt substitutes significantly reduced systolic BP (−5.7 mm Hg; 95% CI −8.5 to −2.8) and diastolic BP (−2.0 mm Hg; 95% CI −3.5 to −0.4). The School-EduSalt study showed that the school-based health education significantly reduced systolic BP among parents (−2.3 mm Hg; 95% CI −4.5 to −0.04).ConclusionsAmong four salt reduction strategies studied in China with RCT design, only salt substitute was proved effective in lowering BP by the pooled effect from multiple studies with high quality. More well-designed studies are warranted for other strategies.

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