The overall quality of evidence based on GRADE criteria was moderate for systolic blood pressure , but low for diastolic blood pressure .
INTERPRETATION Task-sharing interventions are effective in reducing blood pressure .
BACKGROUND Task sharing for the management of hypertension could be useful for understaffed and re source -poor health systems .
We assessed the effectiveness of task-sharing interventions in improving blood pressure control among adults in low-income and middle-income countries .
Cost-Effectiveness of a Comprehensive Approach for Hypertension Control in Low-Income Settings in Argentina: Trial-Based Analysis of the Hypertension Control Program in Argentina.
BACKGROUND A recent cluster r and omized trial evaluating a multicomponent intervention showed significant reductions in blood pressure in low-income hypertensive subjects in Argentina . OBJECTIVES To assess the cost-effectiveness of this intervention . METHODS A total of 1432 hypertensive participants were recruited from 18 primary health care centers . The intervention included home visits led by community health workers , physician education , and text messaging . Re source use and quality of life data using the three-level EuroQol five-dimensional question naire were prospect ively collected . The study perspective was that of the public health care system , and the time horizon was 18 months . Intention-to-treat analysis was used to analyze cost and health outcomes ( systolic blood pressure [ SBP ] change and quality -adjusted life-years [ QALYs ] ) . A 1 time gross domestic product per capita per QALY was used as the cost-effectiveness threshold ( US $ 14,062 ) . RESULTS Baseline characteristics were similar in the two arms . QALYs significantly increased by 0.06 ( 95 % confidence interval [ CI ] 0.04 - 0.09 ) in the intervention group , and SBP net difference favored the intervention group : 5.3 mm Hg ( 95 % CI 0.27 - 10.34 ) . Mean total costs per participant were higher in the intervention arm : US $ 304 in the intervention group and US $ 154 in the control group ( adjusted difference of US $ 140.18 ; 95 % CI US $ 75.41-US $ 204.94 ) . The incremental cost-effectiveness ratio was $ 3299 per QALY ( 95 % credible interval 1635 - 6099 ) and US $ 26 per mm Hg of SBP ( 95 % credible interval 13 - 46 ) . Subgroup analysis showed that the intervention was cost-effective in all prespecified subgroups ( age , sex , cardiovascular risk , and body mass index ) . CONCLUSIONS The multicomponent intervention was cost-effective for blood pressure control among low-income hypertensive patients
The overall quality of evidence based on GRADE criteria was moderate for systolic blood pressure , but low for diastolic blood pressure .
INTERPRETATION Task-sharing interventions are effective in reducing blood pressure .
BACKGROUND Task sharing for the management of hypertension could be useful for understaffed and re source -poor health systems .
We assessed the effectiveness of task-sharing interventions in improving blood pressure control among adults in low-income and middle-income countries .