Cost-effectiveness analysis of psychotherapy in treatment of essential hypertension in primary care
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Aim of the study. To estimate expediency of psychotherapy in patients with essential hypertension from a clinical and economic perspective. Place and duration of study. Clinical material was collected from September 2011 to February 2012 in Polyclinic no. 12, Almaty and the Central City’s Polyclinic, Kaskelen. Method. 75 patients with identified psychosomatic disorders (37 male, 38 female) suffering from hypertension of a first or second degree (from 140/90 to 179/109mmHg) were randomised into two groups (mean age 48.5±3.69 and 47.5±4.2 years). All patients received therapy within the same scheme, but group 1 was additionally treated with psychotherapy. Results. Qualitative improvements were shown on all scales of the “Mini-mult” test for group 1. The control examination of mean blood pressure (BP) at week 14 found a statistically significant difference in final systolic blood pressure (SBP) between the two groups (134.27±3.7 vs. 137.33±3.9, p=0.032), but no such difference in final diastolic blood pressure (DBP) (82.93±5.1 vs. 83.81±4.3, p=0.198). The average cost of the 24-week treatment per person was 47.81USD for group 1 (standard treatment with psychotherapy) and 48.62USD for group 2 (standard treatment). The cost of SBP reduction was 1.98 vs. 2.53USD per 1mmHg for group 1 and 2 respectively and for DBP reduction it was 3.19 vs. 3.73USD per 1mmHg for group 1 and 2 respectively. Blood pressure (BP) reduction was faster in group 1 (7.05 vs. 7.97 weeks). Conclusions. Conservative treatment of hypertension combined with comprehensive psychotherapy leads to better results compared with a conventional conservative treatment scheme, from psychological, clinical and economic points of view, bur results can be different in another country. More trials in different countries with greater numbers of patients are necessary.
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