Skip to main content

Research Repository

Advanced Search

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.

Authors

Rashid J. Ahmed

Amiram Gafni

Eileen K. Hutton

Zheng Jing Hu

Eleanor Pullenayegum

Peter von Dadelszen

Evelyne Rey

Susan Ross

Elizabeth Asztalos

Kellie E. Murphy

Jennifer Menzies

J. Johanna Sanchez

Wessel Ganzevoort

Michael Helewa

Shoo K. Lee

Terry Lee

Alexander G. Logan

Jean-Marie Moutquin

Joel Singer

Jim Thornton

Ross Welch

Laura A. Magee



Abstract

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.

Citation

Ahmed, R. J., Gafni, A., Hutton, E. K., Hu, Z. J., Pullenayegum, E., von Dadelszen, P., …Magee, L. A. (2016). The cost implications of less tight versus tight Control of Hypertension in Pregnancy (CHIPS Trial)novelty and significance. Hypertension, 68(4), 1049-1055. https://doi.org/10.1161/HYPERTENSIONAHA.116.07466

Journal Article Type Article
Acceptance Date Jul 25, 2016
Online Publication Date Aug 22, 2016
Publication Date Sep 1, 2016
Deposit Date Jan 26, 2017
Publicly Available Date Mar 29, 2024
Journal Hypertension
Print ISSN 2224-1485
Electronic ISSN 1524-4563
Publisher Publishing House Zaslavsky
Peer Reviewed Peer Reviewed
Volume 68
Issue 4
Pages 1049-1055
DOI https://doi.org/10.1161/HYPERTENSIONAHA.116.07466
Keywords Blood pressure ; cost analysis ; health policy ; hypertension ; pregnancy ; randomized controlled trials
Public URL https://nottingham-repository.worktribe.com/output/802554
Publisher URL http://hyper.ahajournals.org/content/68/4/1049

Files





You might also like



Downloadable Citations