Can oral vitamin D prevent the cardiovascular diseases among migrants in Australia? Provider perspective using Markov modelling

The study was designed to model the effectiveness and cost effectiveness of oral Vitamin D supplementation as a primary prevention strategy for cardiovascular disease among a migrant population in Australia. It was carried out in the Community Health Service, Kensington, Melbourne. Best-case scenari...

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Main Authors: Ruwanpathirana, T., Owen, A., Renzaho, A., Zomer, E., Gambhir, M., Reid, Christopher
Format: Journal Article
Published: Wiley-Blackwell Publishing Asia 2015
Subjects:
Online Access:http://hdl.handle.net/20.500.11937/14094
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author Ruwanpathirana, T.
Owen, A.
Renzaho, A.
Zomer, E.
Gambhir, M.
Reid, Christopher
author_facet Ruwanpathirana, T.
Owen, A.
Renzaho, A.
Zomer, E.
Gambhir, M.
Reid, Christopher
author_sort Ruwanpathirana, T.
building Curtin Institutional Repository
collection Online Access
description The study was designed to model the effectiveness and cost effectiveness of oral Vitamin D supplementation as a primary prevention strategy for cardiovascular disease among a migrant population in Australia. It was carried out in the Community Health Service, Kensington, Melbourne. Best-case scenario analysis using a Markov model was employed to look at the health care providers’ perspective. Adult migrants who were vitamin D deficient and free from cardiovascular disease visiting the medical centre at least once during the period from 1 January 2010 to 31 December 2012 were included in the study. The blood pressure-lowering effect of vitamin D was taken from a published meta-analysis and applied in the Framingham 10 year cardiovascular risk algorithm (with and without oral vitamin D supplements) to generate the probabilities of cardiovascular events. A Markov decision model was used to estimate the provider costs associated with the events and treatments. Uncertainties were derived by Monte Carlo simulation. Vitamin D oral supplementation (1000 IU/day) for 10 years could potentially prevent 31 (interquartile range (IQR) 26 to 37) non-fatal and 11 (IQR 10 to 15) fatal cardiovascular events in a migrant population of 10 000 assuming 100% compliance. The provider perspective incremental cost effectiveness per year of life saved was AU$3,992 (IQR 583 to 8558). This study suggests subsidised supplementation of oral vitamin D may be a cost effective intervention to reduce non-fatal and fatal cardiovascular outcomes in high-risk migrant populations.
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institution Curtin University Malaysia
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publishDate 2015
publisher Wiley-Blackwell Publishing Asia
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spelling curtin-20.500.11937-140942017-09-13T14:04:52Z Can oral vitamin D prevent the cardiovascular diseases among migrants in Australia? Provider perspective using Markov modelling Ruwanpathirana, T. Owen, A. Renzaho, A. Zomer, E. Gambhir, M. Reid, Christopher framingham risk score cardiovascular disease vitamin D deficiency markov models The study was designed to model the effectiveness and cost effectiveness of oral Vitamin D supplementation as a primary prevention strategy for cardiovascular disease among a migrant population in Australia. It was carried out in the Community Health Service, Kensington, Melbourne. Best-case scenario analysis using a Markov model was employed to look at the health care providers’ perspective. Adult migrants who were vitamin D deficient and free from cardiovascular disease visiting the medical centre at least once during the period from 1 January 2010 to 31 December 2012 were included in the study. The blood pressure-lowering effect of vitamin D was taken from a published meta-analysis and applied in the Framingham 10 year cardiovascular risk algorithm (with and without oral vitamin D supplements) to generate the probabilities of cardiovascular events. A Markov decision model was used to estimate the provider costs associated with the events and treatments. Uncertainties were derived by Monte Carlo simulation. Vitamin D oral supplementation (1000 IU/day) for 10 years could potentially prevent 31 (interquartile range (IQR) 26 to 37) non-fatal and 11 (IQR 10 to 15) fatal cardiovascular events in a migrant population of 10 000 assuming 100% compliance. The provider perspective incremental cost effectiveness per year of life saved was AU$3,992 (IQR 583 to 8558). This study suggests subsidised supplementation of oral vitamin D may be a cost effective intervention to reduce non-fatal and fatal cardiovascular outcomes in high-risk migrant populations. 2015 Journal Article http://hdl.handle.net/20.500.11937/14094 10.1111/1440-1681.12399 Wiley-Blackwell Publishing Asia restricted
spellingShingle framingham risk score
cardiovascular disease
vitamin D deficiency
markov models
Ruwanpathirana, T.
Owen, A.
Renzaho, A.
Zomer, E.
Gambhir, M.
Reid, Christopher
Can oral vitamin D prevent the cardiovascular diseases among migrants in Australia? Provider perspective using Markov modelling
title Can oral vitamin D prevent the cardiovascular diseases among migrants in Australia? Provider perspective using Markov modelling
title_full Can oral vitamin D prevent the cardiovascular diseases among migrants in Australia? Provider perspective using Markov modelling
title_fullStr Can oral vitamin D prevent the cardiovascular diseases among migrants in Australia? Provider perspective using Markov modelling
title_full_unstemmed Can oral vitamin D prevent the cardiovascular diseases among migrants in Australia? Provider perspective using Markov modelling
title_short Can oral vitamin D prevent the cardiovascular diseases among migrants in Australia? Provider perspective using Markov modelling
title_sort can oral vitamin d prevent the cardiovascular diseases among migrants in australia? provider perspective using markov modelling
topic framingham risk score
cardiovascular disease
vitamin D deficiency
markov models
url http://hdl.handle.net/20.500.11937/14094