Clinicoeconomic effectiveness of using psychotherapy to treat patients with essential hypertension

Aim. To assess the expediency of psychotherapy in patients with essential hypertension (EH) from clinical and economic standpoints. Subjects and methods. Seventy-five (37 men, 38 women) with grades 1-2 EH (blood pressure (BP) was 140/90 to 179/109 mm Hg) and the verified psychosomatic background of the disease) were examined and randomized into 2 groups (the mean age in Groups 1 and 2 was 48.5±3.69 and 47.5±4.2 years, respectively). All the patients received medical therapy using the same regimen; however, Group 1 patients had additionally psychotherapy. The decrease in BP and the average number of visits required to reach goal BP were estimated as a criterion for therapeutic effectiveness. A pharmacoeconomic analysis of antihypertensive therapy was made in each group. Results. The average cost for 24 weeks was 349.67 rbl per person in Group 1 and 435.9 rbl in Group 2, which was 19.78% cheaper. The costs of reductions in systolic BP (SBP) and diastolic BP (DBP) were also lower in Group 1 (-22.108 and -39.534 rbl, respectively). At the same time, goal BP was achieved more rapidly in Group 1 (in Groups 1 and 2, the reduction in SBP was 5.28 and 3.38 mm Hg weekly and that in DBP was 2.51 and 1.73 mm Hg weekly, respectively). This makes it possible to lower a physicians' load and to save timing budget (p>0.032). Conclusion. The treatment policy in Group 1 surpassed that in Group 2 in the rate of BP normalization and the number of required visits to a physician and showed significant economic benefits.

essential hypertension, antihypertensive therapy, psychotherapy