(Press-News.org) Expanding health insurance coverage and reducing drug costs that are paid by patients (drug co-payments) in countries without universal free healthcare, such as the United States, may improve the treatment, and control of high blood pressure (hypertension, a condition which affects one billion people worldwide and leads to 7.5 million deaths), according to a study by UK and Canadian researchers published in this week's PLOS Medicine.
Will Maimaris from the London School of Hygiene & Tropical Medicine and colleagues from the Population Health Research Institute and McMaster University in Canada reviewed 53 published studies and found an association between reduced co-payments for health care, including for medications, and improved hypertension control and treatment adherence in multiple US studies, and in studies from Finland, Israel, and Brazil.
The authors also found that in US settings, health insurance coverage and having a routine physician or place of care were linked to improved hypertension outcomes.
However, in their review, the authors found that there were few studies in low-and middle-income countries, which bear most of the global burden of hypertension, and also that there is an urgent need for studies that evaluate how aspects of health care systems other than financing (such as delivery and governance mechanisms) and interactions between health care system arrangements affect hypertension outcomes. The authors argue that without the results of such studies, governments and national and international organizations will not know the best ways to deal effectively with the global public-health crisis posed by hypertension.
The authors say: "This review supports the minimization of medication co-payments in health insurance plans, and although studies were largely conducted in the US, the principle is likely to apply more generally."
They add: "Studies that identify and analyse complexities and links between health systems arrangements and their effects on hypertension management are required, particularly in low-and middle-income countries."
###
Funding: This research was part of the HOPE-4 project. This part of the HOPE-4 project was funded by the Canadian Institutes of Health Research with an award number IHR-120389. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing Interests: The authors have declared that no competing interests exist.
Citation: Maimaris W, Paty J, Perel P, Legido-Quigley H, Balabanova D, et al. (2013) The Influence of Health Systems on Hypertension Awareness, Treatment, and Control: A Systematic Literature Review. PLoS Med 10(7): e1001490. doi:10.1371/journal.pmed.1001490
IN YOUR COVERAGE PLEASE USE THIS URL TO PROVIDE ACCESS TO THE FREELY AVAILABLE PAPER:
http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001490
Contact:
LSHTM Press Office
London School of Hygiene & Tropical Medicine
UNITED KINGDOM
+44 (0)207 927 2802
press@lshtm.ac.uk
Reducing drug costs for patients could improve outcomes for high blood pressure
2013-07-31
ELSE PRESS RELEASES FROM THIS DATE:
Cardiovascular risk in type 2 diabetics with dangerously low blood sugar levels
2013-07-31
Type 2 diabetics who have severe hypoglycaemia are at higher risk of cardiovascular disease, a paper published today on bmj.com suggests.
Severe hypoglycaemia is a condition where there is an abnormally low content of sugar in the blood. It is often classed as a medical emergency.
Severe hypoglycaemia is a potential risk factor for cardiovascular disease in patients with type 2 diabetes and recent clinical trials have failed to demonstrate a beneficial effect of intensive glucose control on overall CVD events.
Although observational studies have reported a positive ...
Increased fluctuation in blood pressure linked to impaired cognitive function in older people
2013-07-31
Higher variability in visit-to-visit blood pressure readings, independent of average blood pressure, could be related to impaired cognitive function in old age in those already at high risk of cardiovascular disease, suggests a paper published today on bmj.com.
There is increasing evidence that vascular factors contribute in development and progression of dementia. This is of special interest as cardiovascular factors may be amendable and thus potential targets to reduce cognitive decline and the incidence of dementia. Visit-to-visit blood pressure variability has been ...
NHS patient information leaflets are 'inaccurate, inconsistent and confusing'
2013-07-31
The NHS's patient information leaflets are "inaccurate, inconsistent, and confusing – and effort is duplicated" argues GP Margaret McCartney on bmj.com.
In a feature published today, Dr McCartney says the NHS is "awash" with patient information and with many trusts commissioning leaflets from external companies and others writing their own, it is difficult to know how efficient and effective these leaflets are.
In a personal view, Dr McCartney says the NHS is "awash" with patient information and with many trusts commissioning leaflets from external companies and others ...
New definition of chronic kidney disease labels 1 in 8 adults as sick
2013-07-31
A new definition of chronic kidney disease labels over 1 in 8 adults and around half of people over 70 years of age as having the disease. Yet low rates of kidney failure suggest many of those diagnosed will never progress to severe disease.
On bmj.com today, Ray Moynihan and colleagues argue this is evidence of overdiagnosis. They call for a re-examination of the definition and urge clinicians to be cautious about labelling patients, particularly older people.
This article is the second of a series looking at the risks and harms of overdiagnosis in a range of common ...
Aquatic playground can turn water tanks into fish schools
2013-07-31
Raising fish in tanks that contain hiding places and other obstacles can make the fish both smarter and improve their chances of survival when they are released into the wild, according to an international team of researchers.
"It's a key problem in that we are very good at rearing fish, but we're really not very good at releasing those animals in the wild such that they survive," said Victoria Braithwaite, professor of fisheries and biology, Penn State. "There's a mismatch between the way we raise them and the real world."
Juvenile Atlantic salmon raised in tanks ...
Controlling contagion by restricting mobility
2013-07-31
In an epidemic or a bioterrorist attack, the response of government officials could range from a drastic restriction of mobility — imposed isolation or total lockdown of a city — to moderate travel restrictions in some areas or simple suggestions that people remain at home. Deciding to institute any measure would require officials to weigh the costs and benefits of action, but at present there's little data to guide them on the question of how disease spreads through transportation networks.
However, a new MIT study comparing contagion rates in two scenarios — with and ...
New approach to treating venomous snakebites could reduce global fatalities
2013-07-31
SAN FRANCISCO (July 30, 2013) – A team of researchers led by Dr. Matt Lewin of the California Academy of Sciences, in collaboration with the Department of Anesthesia at the University of California, San Francisco, has pioneered a novel approach to treating venomous snakebites—administering antiparalytics topically via a nasal spray. This new, needle-free treatment may dramatically reduce the number of global snakebite fatalities, currently estimated to be as high as 125,000 per year. The team demonstrated the success of the new treatment during a recent experiment conducted ...
Lawrence Livermore engineering team makes breakthrough in solar energy research
2013-07-31
LIVERMORE, Calif. – The use of plasmonic black metals could someday provide a pathway to more efficient photovoltaics (PV) --- the use of solar panels containing photovoltaic solar cells --- to improve solar energy harvesting, according to researchers at Lawrence Livermore National Laboratory (LLNL).
The LLNL Materials Engineering Division (MED) research team has made breakthroughs experimenting with black metals. These nanostructured metals are designed to have low reflectivity and high absorption of visible and infrared light. The MED research team recently published ...
Myanmar at the crossroads: Conservationists see opportunities and challenges in biodiversity hotspot
2013-07-31
Long isolated by economic and political sanctions, Myanmar returns to the international community amid high expectations and challenges associated with protecting the country's great natural wealth from the impacts of economic growth and climate change.
In a new study, scientists from the Wildlife Conservation Society have examined the implications of economic development and climatic changes on conserving Myanmar's biodiversity and provide recommendations for conservation planning within a context of a changing climate by strengthening the protected area system and ...
Rensselaer researchers identify cause of LED 'efficiency droop'
2013-07-31
Troy, N.Y. – Rensselaer Polytechnic Institute researchers have identified the mechanism behind a plague of LED light bulbs: a flaw called "efficiency droop" that causes LEDs to lose up to 20 percent of their efficiency as they are subjected to greater electrical currents. Efficiency droop, first reported in 1999, has been a key obstacle in the development of LED lighting for situations, like household lighting, that call for economical sources of versatile and bright light.
In a paper recently published in Applied Physics Letters, the researchers identify a phenomena ...