The cost implications of less tight versus tight Control of Hypertension in Pregnancy (CHIPS Trial)novelty and significance
The CHIPS randomized controlled trial (Control of Hypertension in Pregnancy Study) found no difference in the primary perinatal or secondary maternal outcomes between planned “less tight” (target diastolic 100 mm Hg) and “tight” (target diastolic 85 mm Hg) blood pressure management strategies among...
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| Format: | Article |
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American Heart Association
2016
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| Online Access: | https://eprints.nottingham.ac.uk/40111/ |
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| author | Ahmed, Rashid J. Gafni, Amiram Hutton, Eileen K. Hu, Zheng Jing Pullenayegum, Eleanor von Dadelszen, Peter Rey, Evelyne Ross, Susan Asztalos, Elizabeth Murphy, Kellie E. Menzies, Jennifer Sanchez, J. Johanna Ganzevoort, Wessel Helewa, Michael Lee, Shoo K. Lee, Terry Logan, Alexander G. Moutquin, Jean-Marie Singer, Joel Thornton, Jim Welch, Ross Magee, Laura A. |
| author_facet | Ahmed, Rashid J. Gafni, Amiram Hutton, Eileen K. Hu, Zheng Jing Pullenayegum, Eleanor von Dadelszen, Peter Rey, Evelyne Ross, Susan Asztalos, Elizabeth Murphy, Kellie E. Menzies, Jennifer Sanchez, J. Johanna Ganzevoort, Wessel Helewa, Michael Lee, Shoo K. Lee, Terry Logan, Alexander G. Moutquin, Jean-Marie Singer, Joel Thornton, Jim Welch, Ross Magee, Laura A. |
| author_sort | Ahmed, Rashid J. |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | The CHIPS randomized controlled trial (Control of Hypertension in Pregnancy Study) found no difference in the primary perinatal or secondary maternal outcomes between planned “less tight” (target diastolic 100 mm Hg) and “tight” (target diastolic 85 mm Hg) blood pressure management strategies among women with chronic or gestational hypertension. This study examined which of these management strategies is more or less costly from a third-party payer perspective. A total of 981 women with singleton pregnancies and nonsevere, nonproteinuric chronic or gestational hypertension were randomized at 14 to 33 weeks to less tight or tight control. Resources used were collected from 94 centers in 15 countries and costed as if the trial took place in each of 3 Canadian provinces as a cost-sensitivity analysis. Eleven hospital ward and 24 health service costs were obtained from a similar trial and provincial government health insurance schedules of medical benefits. The mean total cost per woman–infant dyad was higher in less tight versus tight control, but the difference in mean total cost (DM) was not statistically significant in any province: Ontario ($30191.62 versus $24469.06; DM $5723, 95% confidence interval, −$296 to $12272; P=0.0725); British Columbia ($30593.69 versus $24776.51; DM $5817; 95% confidence interval, −$385 to $12349; P=0.0725); or Alberta ($31510.72 versus $25510.49; DM $6000.23; 95% confidence interval, −$154 to $12781; P=0.0637). Tight control may benefit women without increasing risk to neonates (as shown in the main CHIPS trial), without additional (and possibly lower) cost to the healthcare system. |
| first_indexed | 2025-11-14T19:40:49Z |
| format | Article |
| id | nottingham-40111 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T19:40:49Z |
| publishDate | 2016 |
| publisher | American Heart Association |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-401112020-05-04T18:03:55Z https://eprints.nottingham.ac.uk/40111/ The cost implications of less tight versus tight Control of Hypertension in Pregnancy (CHIPS Trial)novelty and significance Ahmed, Rashid J. Gafni, Amiram Hutton, Eileen K. Hu, Zheng Jing Pullenayegum, Eleanor von Dadelszen, Peter Rey, Evelyne Ross, Susan Asztalos, Elizabeth Murphy, Kellie E. Menzies, Jennifer Sanchez, J. Johanna Ganzevoort, Wessel Helewa, Michael Lee, Shoo K. Lee, Terry Logan, Alexander G. Moutquin, Jean-Marie Singer, Joel Thornton, Jim Welch, Ross Magee, Laura A. The CHIPS randomized controlled trial (Control of Hypertension in Pregnancy Study) found no difference in the primary perinatal or secondary maternal outcomes between planned “less tight” (target diastolic 100 mm Hg) and “tight” (target diastolic 85 mm Hg) blood pressure management strategies among women with chronic or gestational hypertension. This study examined which of these management strategies is more or less costly from a third-party payer perspective. A total of 981 women with singleton pregnancies and nonsevere, nonproteinuric chronic or gestational hypertension were randomized at 14 to 33 weeks to less tight or tight control. Resources used were collected from 94 centers in 15 countries and costed as if the trial took place in each of 3 Canadian provinces as a cost-sensitivity analysis. Eleven hospital ward and 24 health service costs were obtained from a similar trial and provincial government health insurance schedules of medical benefits. The mean total cost per woman–infant dyad was higher in less tight versus tight control, but the difference in mean total cost (DM) was not statistically significant in any province: Ontario ($30191.62 versus $24469.06; DM $5723, 95% confidence interval, −$296 to $12272; P=0.0725); British Columbia ($30593.69 versus $24776.51; DM $5817; 95% confidence interval, −$385 to $12349; P=0.0725); or Alberta ($31510.72 versus $25510.49; DM $6000.23; 95% confidence interval, −$154 to $12781; P=0.0637). Tight control may benefit women without increasing risk to neonates (as shown in the main CHIPS trial), without additional (and possibly lower) cost to the healthcare system. American Heart Association 2016-09-01 Article PeerReviewed Ahmed, Rashid J., Gafni, Amiram, Hutton, Eileen K., Hu, Zheng Jing, Pullenayegum, Eleanor, von Dadelszen, Peter, Rey, Evelyne, Ross, Susan, Asztalos, Elizabeth, Murphy, Kellie E., Menzies, Jennifer, Sanchez, J. Johanna, Ganzevoort, Wessel, Helewa, Michael, Lee, Shoo K., Lee, Terry, Logan, Alexander G., Moutquin, Jean-Marie, Singer, Joel, Thornton, Jim, Welch, Ross and Magee, Laura A. (2016) The cost implications of less tight versus tight Control of Hypertension in Pregnancy (CHIPS Trial)novelty and significance. Hypertension, 68 (4). pp. 1049-1055. ISSN 1524-4563 Blood pressure ; cost analysis ; health policy ; hypertension ; pregnancy ; randomized controlled trials http://hyper.ahajournals.org/content/68/4/1049 doi:10.1161/HYPERTENSIONAHA.116.07466 doi:10.1161/HYPERTENSIONAHA.116.07466 |
| spellingShingle | Blood pressure ; cost analysis ; health policy ; hypertension ; pregnancy ; randomized controlled trials Ahmed, Rashid J. Gafni, Amiram Hutton, Eileen K. Hu, Zheng Jing Pullenayegum, Eleanor von Dadelszen, Peter Rey, Evelyne Ross, Susan Asztalos, Elizabeth Murphy, Kellie E. Menzies, Jennifer Sanchez, J. Johanna Ganzevoort, Wessel Helewa, Michael Lee, Shoo K. Lee, Terry Logan, Alexander G. Moutquin, Jean-Marie Singer, Joel Thornton, Jim Welch, Ross Magee, Laura A. The cost implications of less tight versus tight Control of Hypertension in Pregnancy (CHIPS Trial)novelty and significance |
| title | The cost implications of less tight versus tight Control of Hypertension in Pregnancy (CHIPS Trial)novelty and significance |
| title_full | The cost implications of less tight versus tight Control of Hypertension in Pregnancy (CHIPS Trial)novelty and significance |
| title_fullStr | The cost implications of less tight versus tight Control of Hypertension in Pregnancy (CHIPS Trial)novelty and significance |
| title_full_unstemmed | The cost implications of less tight versus tight Control of Hypertension in Pregnancy (CHIPS Trial)novelty and significance |
| title_short | The cost implications of less tight versus tight Control of Hypertension in Pregnancy (CHIPS Trial)novelty and significance |
| title_sort | cost implications of less tight versus tight control of hypertension in pregnancy (chips trial)novelty and significance |
| topic | Blood pressure ; cost analysis ; health policy ; hypertension ; pregnancy ; randomized controlled trials |
| url | https://eprints.nottingham.ac.uk/40111/ https://eprints.nottingham.ac.uk/40111/ https://eprints.nottingham.ac.uk/40111/ |