Cost-effectiveness analysis of psychotherapy in treatment of essential hypertension on the primary care level
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School Of Public Health, Ministry of health
Submission date: 2014-06-17
Final revision date: 2014-08-01
Acceptance date: 2014-08-12
Publication date: 2014-12-29
Corresponding author
Ainur Zholamanova   

School Of Public Health, Ministry of health, Utepova str., 19a, 050060 Almaty, Kazakhstan
Arch Psych Psych 2014;16(4):57-63
Aim of the study:
estimate expediency of psychotherapy in patients with essential hypertension with clinical and economic perspectives.

Subject or material and methods:
75 patients with identified psychosomatic disorders (37 men, 38 female) suffering from hypertension 1-2 degrees (from 140/90 to 179/109 mm Hg), were randomized into 2 groups (mean age is 48,5±3,69, and 47,5±4,2 years). All patients received therapy by the same scheme, but 1ST group of patients additionally treated with psychotherapy.

Mini-mult test showed qualitative improvements on all scales for the 1st group. The control examination of the mean blood pressure at week 14 found statistically significant difference between final systolic blood pressure of two groups (134.27±3.7 vs. 137.33±3.9, p=0.032), but no such difference in final diastolic blood pressure (82.93±5.1 vs. 83.81±4.3, p=0.198). The average cost for 24 weeks for 1 person is 47.81 USD and 48,62 USD respectively. Costs of reductions of SBP is 1.98 USD vs. 2,53 USD and DBP 3.19 USD vs 3.73 USD per 1 mm. Hg. BP level reduction is faster in the 1st group (7.05 weeks vs. 7.97 weeks).

Economical results are relevant to the Republic of Kazakhstan, but for use in another country with another organization of the health system, it will be different.

conservative therapy of hypertension combined with comprehensive psychotherapy leads to better results compared with a conventional conservative treatment scheme, from psychological, clinical and economical points of view, bur results can be different in the another country. More trials in different countries with bigger number of patients are necessary.

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