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Comparative effectiveness of guidelines for the management of hyperlipidemia and hypertension for type 2 diabetes patients

Shah, ND and Mason, J and Kurt, M and Denton, BT and Schaefer, AJ and Montori, VM and Smith, SA (2011) Comparative effectiveness of guidelines for the management of hyperlipidemia and hypertension for type 2 diabetes patients. PLoS ONE, 6 (1).

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Abstract

Background: Several guidelines to reduce cardiovascular risk in diabetes patients exist in North America, Europe, and Australia. Their ability to achieve this goal efficiently is unclear. Methods and Findings: Decision analysis was used to compare the efficiency and effectiveness of international contemporary guidelines for the management of hypertension and hyperlipidemia for patients aged 40-80 with type 2 diabetes. Measures of comparative effectiveness included the expected probability of a coronary or stroke event, incremental medication costs per event, and number-needed-to-treat (NNT) to prevent an event. All guidelines are equally effective, but they differ significantly in their medication costs. The range of NNT to prevent an event was small across guidelines (6.5-7.6 for males and 6.5-7.5 for females); a larger range of differences were observed for expected cost per event avoided (ranges, $117,269-$157,186 for males and $115,999-$163,775 for females). Australian and U.S. guidelines result in the highest and lowest expected costs, respectively. Conclusions: International guidelines based on the same evidence and seeking the same goal are similar in their effectiveness; however, there are large differences in expected medication costs. © 2011 Shah et al.

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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Shah, ND
Mason, J
Kurt, M
Denton, BT
Schaefer, AJschaefer@pitt.eduSCHAEFER
Montori, VM
Smith, SA
Date: 7 February 2011
Date Type: Publication
Journal or Publication Title: PLoS ONE
Volume: 6
Number: 1
DOI or Unique Handle: 10.1371/journal.pone.0016170
Schools and Programs: Swanson School of Engineering > Industrial Engineering
Refereed: Yes
MeSH Headings: Australia; Cost-Benefit Analysis; Decision Support Techniques; Diabetes Complications--drug therapy; Diabetes Complications--economics; Diabetes Mellitus, Type 2--complications; Diabetes Mellitus, Type 2--drug therapy; Disease Management; Drug Costs; Europe; Female; Humans; Hyperlipidemias--complications; Hyperlipidemias--drug therapy; Hyperlipidemias--economics; Hypertension--complications; Hypertension--drug therapy; Hypertension--economics; Male; North America; Practice Guidelines as Topic--standards
Other ID: NLM PMC3026790
PubMed Central ID: PMC3026790
PubMed ID: 21283569
Date Deposited: 03 Aug 2012 16:06
Last Modified: 05 Feb 2018 22:55
URI: http://d-scholarship.pitt.edu/id/eprint/13256

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