scholarly journals Cost-effectiveness of Hypertension Treatment by Pharmacists in Black Barbershops

Circulation ◽  
2021 ◽  
Author(s):  
Kelsey B. Bryant ◽  
Andrew E. Moran ◽  
Dhruv S. Kazi ◽  
Yiyi Zhang ◽  
Joanne Penko ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Cost Effectiveness ◽  
Los Angeles ◽  
Black Men ◽  
Blood Pressure Control ◽  
Healthcare Costs ◽  
Cost Effective ◽  
Pressure Control ◽  
Healthcare Sector

Background: In the Los Angeles Barbershop Blood Pressure Study (LABBPS), pharmacist-led hypertension care in Los Angeles County Black-owned barbershops significantly improved blood pressure control in non-Hispanic Black men with uncontrolled hypertension at baseline. In this analysis, 10-year health outcomes and healthcare costs of one year of the LABBPS intervention versus control are projected. Methods: A discrete event simulation of hypertension care processes projected blood pressure, medication-related adverse events, fatal and non-fatal cardiovascular disease events, and non-cardiovascular disease death in LABBPS participants. Program costs, total direct healthcare costs (2019 USD), and quality-adjusted life years (QALYs) were estimated for the LABBPS intervention and control arms from a healthcare sector perspective over a 10-year horizon. Future costs and QALYs were discounted 3% annually. High and intermediate cost-effectiveness thresholds were defined as <$50,000 and <$150,000 per QALY gained, respectively. Results: At 10 years, the intervention was projected to cost an average of $2,356 (95% uncertainty interval [UI] -$264-$4,611) more per participant than the control arm and gain 0.06 (95% UI 0.01-0.10) QALYs. The LABBPS intervention was highly cost-effective, with a mean cost of $42,717 per QALY gained (58% probability of being highly and 96% of being at least intermediately cost-effective). Exclusive use of generic drugs improved the cost-effectiveness to $17,162 per QALY gained. The LABBPS intervention would be only intermediately cost effective if pharmacists were less likely to intensify antihypertensive medications when systolic blood pressure was ≥150 mmHg or if pharmacist weekly time driving to barbershops increased. Conclusions: Hypertension care delivered by clinical pharmacists in Black barbershops is a highly cost-effective way to improve blood pressure control in Black men.

Abstract 21: Telemedicine And The Barbershop Model Of Hypertension Care For Black Men

Hypertension ◽  
2020 ◽  
Vol 76 (Suppl_1) ◽  
Author(s):  
Ciantel A Blyler ◽  
Mohamad Rashid ◽  
Norma B Moy ◽  
Kayslee A Kemp ◽  
Florian Rader
Keyword(s):  
Blood Pressure ◽  
Los Angeles ◽  
Black Men ◽  
Medication Management ◽  
Cost Effective ◽  
Serious Adverse Events ◽  
Blood Pressure Study ◽  
Collaborative Practice Agreement ◽  
The Cost

Background: The Los Angeles Barbershop Blood Pressure Study (LABBPS) demonstrated both efficacy and sustainability of a new model of hypertension (HTN) care for non-Hispanic black men that links health promotion by barbers to medication management by specialty-trained pharmacists. Barriers to scaling the model include logistical inefficiencies that contribute to the cost of the intervention. Most notable was the amount of time pharmacists spent traveling between barbershops. To address this, we tested whether telemedicine (remote follow-up) could be substituted for in-person visits after blood pressure (BP) control was achieved. Methods: We enrolled 10 black male patrons with systolic BP ≥ 140 mm Hg in this proof-of-concept study in which barbers promoted follow-up with pharmacists who initially met each patron in the barbershop where they prescribed BP medication under a collaborative practice agreement with the patrons’ physician. Medications were titrated during bimonthly in-person visits to achieve a BP goal of ≤130/80 mmHg. Once BP goal was reached, monthly visits were done by videoconference while barbers assisted with BP checks. Final BP and safety outcomes were assessed at 12 months. Results: After exclusion of one participant who declined adherence, 9 patients completed the intervention. Baseline BP of 155 + 14 / 83 + 11 mmHg decreased by 29 + 13 / 8.9 + 15 mmHg (p<.0001), with eight participants (89%) achieving systolic control and seven (78%) diastolic control at 12 months. These new data are statistically indistinguishable from our previous LABBPS data (p=0.8 for both change in systolic BP and diastolic BP). Overall HTN control (≤ 130/80) was 67% (6 of 9), numerically greater than the 63% observed in LABBPS (p=N.S.). As intended, the mean number of in-person pharmacist visits per patron fell from 11 in LABBPS to 6.6 visits over 12 months. No treatment-related serious adverse events occurred. Cohort retention was 90%. Conclusions: Telemedicine represents a viable substitute for in-person visits, both improving pharmacist efficiency and reducing cost while preserving intervention potency. These findings are crucial for future broad-scale implementation efforts and development of cost-effective barbershop HTN management programs for black men.

scholarly journals EFFECTS OF INTENSIVE BLOOD PRESSURE CONTROL IN PATIENTS WITH EVIDENT CARDIOVASCULAR DISEASE

2018 ◽  
Vol 71 (11) ◽  
pp. A1914
Author(s):  
Dimitrios Terentes-Printzios ◽  
Charalambos Vlachopoulos ◽  
Konstantinos Aznaourids ◽  
Nikolaos Ioakeimidis ◽  
Panagiotis Xaplanteris ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Blood Pressure Control ◽  
Pressure Control ◽  
Intensive Blood Pressure

Cost-effectiveness of educational interventions to improve patient outcomes in blood pressure control

1985 ◽  
Vol 14 (6) ◽  
pp. 782-800 ◽  
Author(s):  
Joel C. Cantor ◽  
Donald E. Morisky ◽  
Lawrence W. Green ◽  
David M. Levine ◽  
David S. Salkever
Keyword(s):  
Blood Pressure ◽  
Cost Effectiveness ◽  
Patient Outcomes ◽  
Blood Pressure Control ◽  
Pressure Control ◽  
Educational Interventions ◽  
Improve Patient

scholarly journals Daily Almond Consumption in Cardiovascular Disease Prevention via LDL-C Change in the U.S. Population: a Cost-Effectiveness Analysis

2019 ◽  
Author(s):  
Jifan Wang(New Corresponding Author) ◽  
Michelle A. Lee Bravatti ◽  
Elizabeth J. Johnson ◽  
Gowri Raman(Former Corresponding Author)
Keyword(s):  
Cardiovascular Disease ◽  
Cost Effectiveness ◽  
Willingness To Pay ◽  
Cost Effective ◽  
Dietary Factors ◽  
Sensitivity Analyses ◽  
Healthcare Sector ◽  
Cvd Prevention ◽  
The Cost ◽  
The U.S

Abstract Objectives Heart disease is the leading cause of death in the United States. The U.S. Food and Drug Administration approved the health claim that 1.5 ounces (42.5 grams) of nut intake may reduce the risk of cardiovascular disease (CVD). Previous studies have focused on the cost-effectiveness of other foods or dietary factors on primary CVD prevention, yet not in almond consumption. This study aimed to examine the cost-effectiveness of almond consumption in CVD primary prevention. Perspective & Setting This study assessed the cost-effectiveness of consuming 42.5 grams of almond from the U.S. healthcare sector perspective. Methods A decision model was developed for 42.5 grams of almond per day versus no almond consumption and CVD in the U.S. population. Parameters in the model were derived from the literature, which included the probabilities of increasing LDL-C, developing acute myocardial infarction (MI) and stroke, treating MI, dying from the disease and surgery, as well as the costs of the disease and procedures in the U.S. population, and the quality-adjusted life years (QALY). The cost of almonds was based on the current price in the U.S. market. Sensitivity analyses were conducted for different levels of willingness-to-pay, the probabilistic sensitivity analysis, ten-year risk prevention, different costs of procedures and almond prices, and patients with or without CVD. Results The almond strategy had $363 lower cost and 0.02 higher QALY gain compared to the non-almond strategy in the base-case model. The annual net monetary benefit (NMB) of almond consumption was $1,421 higher per person than no almond consumption, when the willingness to pay threshold was set at $50,000 for annual health care expenditure. Almond was more cost-effective than non-almond in CVD prevention in all the sensitivity analyses. Conclusion Consuming 42.5 grams of almonds per day is a cost-effective approach to prevent CVD in the short term and potentially in the long term.

Sign in / Sign up

Export Citation Format

Share Document