Λεπτομέρειες βιβλιογραφικής εγγραφής
| Τίτλος: |
A Cardiovascular Care Pathway Supported by Remote Patient Management in Dutch Primary Care: Cost-Effectiveness, Budget Impact, and Workload Analysis |
| Συγγραφείς: |
Heijdra Suasnabar, Jan, Rakers, Margot, van Hattem, Nicoline, Hiddink, Eric, Haas, Marcel, Zhang, Xuerui, Atsma, Douwe, Bonten, Tobias N, van den Akker-van Marle, M Elske, van Os, Hendrikus J A, Brain, AIOS Psychiatrie |
| Έτος έκδοσης: |
2026 |
| Θεματικοί όροι: |
Humans, Netherlands, Cost-Benefit Analysis/methods, Cost-Effectiveness Analysis/methods, Primary Health Care/statistics & numerical data, Cardiovascular Diseases/therapy, Remote Patient Monitoring, Budgets/statistics & numerical data, Workload/statistics & numerical data, Male, Female, Middle Aged, Markov Chains, Aged, Journal Article |
| Περιγραφή: |
BACKGROUND: Remote patient management (RPM) that supports patient self-monitoring of vital parameters and lifestyle factors may improve cardiovascular risk management (CVRM) in primary care. However, large-scale implementation remains limited, partly due to insufficient evidence on long-term value for money, budget impact, and implications for health care professionals' workload. OBJECTIVE: This study aimed to estimate the long-term cost-effectiveness, 5-year health care budget impact, and expected changes in general practitioner (GP) and practice nurse (PN) workload associated with the CVRM-Box intervention in the Netherlands. METHODS: We conducted a model-based economic evaluation comparing CVRM-Box with care as usual in Dutch primary care integrated CVRM programs. CVRM-Box is a multicomponent RPM intervention comprising a digital blood pressure (BP) monitor, digital weight scale, step counter/activity tracker, and a mobile app, with measurements transferred to the GP practice for periodic review. A time-inhomogeneous cohort Markov model simulated lifetime transitions among health states, including at-risk, post-myocardial infarction (MI), poststroke, recurrent events, cardiovascular death, and noncardiovascular death. Cardiovascular risks were modeled using prediction equations (SCORE2, SCORE2-OP, and SMART2) populated with subgroup-specific risk factor profiles. Intervention effects were modeled as changes in systolic BP derived from a matched cohort study of CVRM-Box. Other key parameters (costs and utilities) were similarly obtained from the matched cohort study, or routine primary care data, and published sources. Outcomes included incremental cost-effectiveness ratios (ICERs, indicating cost per quality-adjusted life year [QALY] gained), cost-effectiveness probabilities, 5-year health care budget impact, and an exploratory workload analysis estimating annual changes in visit time and remote consultation frequency for GPs and PNs. Probabilistic and scenario uncertainty analyses were performed. RESULTS: In ... |
| Τύπος εγγράφου: |
article in journal/newspaper |
| Περιγραφή αρχείου: |
application/pdf |
| Γλώσσα: |
English |
| ISSN: |
2291-5222 |
| Relation: |
https://dspace.library.uu.nl/handle/1874/491548 |
| Διαθεσιμότητα: |
https://dspace.library.uu.nl/handle/1874/491548 |
| Rights: |
info:eu-repo/semantics/OpenAccess |
| Αριθμός Καταχώρησης: |
edsbas.E099E6AB |
| Βάση Δεδομένων: |
BASE |