印度心血管干预经济证据的系统性回顾。

IF 2.4 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Saba Abidi, Anandita Nair, Rakhi Ahuja, Shridhar Dwivedi, Sushama Talegaonkar
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引用次数: 0

摘要

背景:心血管疾病(CVD)仍然是全球死亡的主要原因,在印度也不例外。印度心血管疾病发病率的快速飙升迫切需要推广现代、可持续和具有成本效益的干预措施,以解决心血管疾病造成的负担。本系统性综述整合了有关各种干预措施成本效益的研究证据,这些干预措施可用于控制印度的心血管疾病:方法:在 PubMed、Cochrane Library、Embase 和 Google Scholar 等数据库中搜索了 30 年间(1991-2021 年)印度人口心血管疾病干预措施的经济评估数据。两名审稿人对文章进行了资格评估,并按照预先确定的模板从入围文章中提取数据,包括方法学方面的量化:共审查了 1249 项研究,其中 23 项完全符合全文审查的纳入标准。共有 16 项研究仅以印度人口为对象,其余(7 项)的干预措施包括南亚/亚洲,其中印度是参与国之一。大多数经济评估针对的是心血管疾病的治疗或药物干预措施(14 项)。这些评估基于决策模型(10 项)、随机对照试验(9 项)和观察研究(4 项)。由于研究方法的不同,如研究环境、研究人群和研究设计的不一致,纳入研究的成本效益比呈现出不同的范围。研究发现,初级和一级预防的平均 ICER(增量成本效益比)分别为 3073.8(2022 美元)和 17489.9(2022 美元)。此外,二级和三级预防的综合平均值为 2029.6(2022 美元):结论:公共卫生干预措施的经济学证据正在扩大,但其重点仅限于药物干预。现在迫切需要强调初级和一级预防,以便在卫生经济决策中取得更好的结果。需要进一步探索基于技术的干预途径,以满足印度这样一个人口大国的需求。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Systematic Review of Economic Evidence of Cardiovascular Interventions in India.

Background: Cardiovascular diseases (CVDs) continue to be the primary cause of mortality globally and invariably in India as well. The rapid upsurge in the prevalence of CVDs in India has created a pressing need to promote contemporary, sustainable, and cost-effective interventions to tackle the CVD burden. This systematic review integrates the research-based evidence of the cost-effectiveness of various interventions that can be adapted to control CVDs in India.

Methods: Databases, namely, PubMed, Cochrane Library, Embase, and Google Scholar, were searched for data on the economic evaluation of interventions targeting CVD based on the Indian population for a period of 30 years (1991-2021). Two reviewers assessed the articles for eligibility, and data were extracted from the shortlisted articles as per a predefined template, including the quantification of methodological aspects.

Results: In total, 1249 studies were examined, out of which 23 completely met the inclusion criteria for full-text review. A total of 16 studies were based solely on the Indian population, while the rest (7) included South Asia/Asia for the intervention, of which India was a participant nation. Most of the economic evaluations targeted treatment-based or pharmacological interventions (14) for CVDs. The evaluations were based on Decision-based models (10), Randomized controlled Trials (RCTs) (9), and Observational studies (4). The cost-effectiveness ratio for the included studies exhibited a diverse range due to variations in methodological approaches, such as differences in study settings, populations, and inconsistencies in study design. The mean ICER (Incremental Cost-effectiveness ratio) for primordial and primary preventions was found to be 3073.8 (US $2022) and 17489.9 (US $2022), respectively. Moreover, the combined mean value for secondary and tertiary prevention was 2029.6 (US$2022).

Conclusion: The economic evidence of public health interventions are expanding, but their focus is restricted towards pharmacological interventions. There is an urgency to emphasize primordial and primary prevention for better outcomes in health economics decision-making. Technology- based avenues for intervention need more exploration in order to cater to a large population like India.

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来源期刊
Current Cardiology Reviews
Current Cardiology Reviews CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
3.70
自引率
10.50%
发文量
117
期刊介绍: Current Cardiology Reviews publishes frontier reviews of high quality on all the latest advances on the practical and clinical approach to the diagnosis and treatment of cardiovascular disease. All relevant areas are covered by the journal including arrhythmia, congestive heart failure, cardiomyopathy, congenital heart disease, drugs, methodology, pacing, and preventive cardiology. The journal is essential reading for all researchers and clinicians in cardiology.
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