Medical effectiveness and cost-effectiveness of a multidisciplinary team-based approach to the management of community residents with hypertension: an analysis of an interventional follow-up study

Abstract

Background This study assessed the medical effectiveness and cost-effectiveness of a multidisciplinary team (MDT)-based interventional follow-up in managing hypertension, thereby serving as an evidence base for decision-making in disease prevention and control for community residents. Methods We randomly assigned 5,676 community residents in Shanghai’s Changning District to the intervention or the control group and followed them up for two years. Results The mean BP of the intervention group decreased from 132.28/79.55 mmHg to 130.73/77.62 mmHg after the follow-up. The prevalence of hypertension in the intervention group (86.1%, n = 2,450) was lower than in the control group (89.8%, n = 2,510) (odds ratio (OR) = 1.30, 95% confidence interval (CI): 1.09–1.58, P = 0.004). The ICER of the intervention group was ¥6,837 ($989.135, £792.135) in cost analysis, with the threshold of cost-effectiveness set as the incremental costs per QALY, which was 0.63 times China’s 2017 GDP (gross domestic product) per capita (¥59,960). Additionally, the incremental costs of the intervention group totaled ¥5,128.394 with a QALY value of 2.018, while those of the control group were ¥4,855.406 with a QALY value of 1.978. The ICER of ¥6,837/QALY in the intervention group was far less than 0.63 times China’s 2017GDP per capita (¥59,960), suggesting the economic feasibility of the interventional strategy. Conclusions The MDT-based intervention is a highly cost-effective strategy, and it effectively reduces the prevalence of hypertension in community residents, the occurrence of MACEs, and the mortality rate from CVDs while providing scientific medication guidance. Trial registration: item number 134119b2200.