IMPROVEMENT OF LONG TERM RISKS OF CARDIOVASCULAR EVENTS ASSOCIATED WITH COMMUNITY BASED DISEASE MANAGEMENT IN CHINESE PATIENTS OF THE XIN JIANG AUTONOMOUS REGION OF CHINA

Author(s)

Yang L1, Cai M1, Ma M2, Huang X2, Liu L3, Wang B4, Zhu M5, Zhu W2, Zhe W3, Guan Y3, Kongnakorn T6, Peng S7, Hach T8
1Peking University, Beijing, China, 2Health and Family Planning Commission of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang Uygur Autonomous Region, China, 3Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention, Urumqi, Xinjiang Uygur Autonomous Region, China, 4Novartis Pharmaceuticals (China), Shanghai, China, 5Novartis Group China, Beijing, China, 6Evidera, Bangkok, Thailand, 7Evidera, Bethesda, MD, USA, 8Novartis International AG, Basel, Switzerland

OBJECTIVES: A recent community-based disease management (CBDM) pilot study reported a 20.45% prevalence of hypertension and a 0.5% and 3.6% prevalence of stroke and coronary heart disease (CHD), respectively, in an elderly population (mean age 65 years) in the Xin Jiang autonomous region of China. The CBDM was initiated in 2013 as an essential public health service; however, the potential long-term impact of CBDM on cardiovascular (CV) events is unknown. METHODS: A discrete event simulation was developed to evaluate the impact of CBDM on long-term CV risks among patients with hypertension in China’s Xin Jiang autonomous region. The model generated pairs of identical patients; one receives CBDM and one does not (control group). Their clinical courses were simulated based on times to CV events (CHD and strokes), which are estimated using published risk equations. The impact of CBDM was incorporated as improvement in systolic blood pressure (SBP) based on observations from the CBDM study. The simulation estimated the number of CV events over patients’ lifetimes.   RESULTS: During a 2-year follow up, the CBDM led to an average 8.67 mmHg reduction in SBP from baseline, and reduced smoking from 11.02% at baseline to 6.35%. The discrete event simulation showed that, in the control group, the model estimated incidence rates of 289, 1765, and 304 per 100,000 individuals for lifetime CHD, stroke, and CV-related death, respectively. CBDM’s impact on SBP translated into reductions of 13%, 26%, and 17% in CHD, strokes, and CV-related deaths, respectively. Taking into account CBDM’s reduction of both SBP and smoking, deaths from CHD, stroke, and CV-related death were reduced by 17%, 28%, and 19%, respectively.  CONCLUSIONS: The implementation of CBDM in China’s Xin Jiang autonomous region is expected to significantly reduce incidences of CHD, strokes, and CV-related deaths.

Conference/Value in Health Info

2016-09, ISPOR Asia Pacific 2016, Singapore

Value in Health, Vol. 19, No. 7 (November 2016)

Code

PCV9

Topic

Clinical Outcomes, Epidemiology & Public Health

Topic Subcategory

Comparative Effectiveness or Efficacy

Disease

Cardiovascular Disorders

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