正念减压辅助治疗高血压的成本-效果分析：基于12个月随访

Objective To compare the clinical efficacy of conventional medication and mindfulness-based stress reduction(MBSR) combined with medication in the treatment of hypertension during 12-month follow-up, and to conduct a cost-effectiveness analysis. Methods The study was a secondary analysis based on data from previous randomized controlled trial. 40 patients in the conventional treatment group received routine antihypertensive drugs, while 42 patients in the MBSR group received an 8-week mindfulness-based stress reduction intervention on the basis of conventional medication. All patients entered a 12-month follow-up after the 8-week intervention. The clinical efficacy and adverse reactions were compared at the end of follow-up. The drug and other medical costs during the follow-up period were calculated, and the cost-effectiveness ratio and incremental cost-effectiveness ratio were determined. A sensitivity analysis was performed by reducing the overall medical cost by 10%. Results One case was lost to follow-up in each group, with 39 patients in the conventional treatment group and 41 patients in the MBSR group finally included. The total clinical effective rate of the MBSR group was 87.80%, which was higher than 82.05% of the conventional treatment group, and the difference was statistically significant(P=0.003). The incidence of adverse reactions was 9.76% and 10.26% in the MBSR group and conventional treatment group, respectively, with no significant difference(P=0.941). The costeffectiveness ratios of the conventional group and MBSR group were 5.21 and 4.36, respectively, with an incremental cost-effectiveness ratio of-7.82. Sensitivity analysis verified the stability of the results. Conclusion Mindfulness-based stress reduction combined with conventional medication yields better long-term efficacy and favorable cost-effectiveness.