Evidence map›Paper›PMID 31067190›Full record

Trial reportHypertension (Dallas, Tex. : 1979)2019

Cost-Effectiveness of Telemonitoring and Self-Monitoring of Blood Pressure for Antihypertensive Titration in Primary Care (TASMINH4).

Mark Monahan, Sue Jowett, Alecia Nickless, Marloes Franssen, Sabrina Grant, Sheila Greenfield, F D Richard Hobbs, James Hodgkinson, Jonathan Mant, Richard J McManus

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Hypertension (Dallas, Tex. : 1979), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 62 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
62citing papers in PubMed, 10 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

62 citing papers in PubMed, 10 syntheses or guidelines pooled it.

  1. Smartphone application-based interventions for cardiometabolic risk factor management: A systematic review and meta-analysis.Hypertension research : official journal of the Japanese Society of Hypertension · 2026
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  9. Guideline
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  12. Phone-based telemonitoring of arterial hypertension versus usual care: the HOROSCOPE study.Hypertension research : official journal of the Japanese Society of Hypertension · 2025
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2 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Mark MonahanFrom the Institute of Applied Health Research, University of Birmingham, United Kingdom (M.M., S.J., S. Greenfield, J.H.).
Sue JowettFrom the Institute of Applied Health Research, University of Birmingham, United Kingdom (M.M., S.J., S. Greenfield, J.H.).
Alecia NicklessNuffield Department of Primary Care Health Sciences, University of Oxford, United Kingdom (A.N., M.F., F.D.R.H., R.J.M.).
Marloes FranssenNuffield Department of Primary Care Health Sciences, University of Oxford, United Kingdom (A.N., M.F., F.D.R.H., R.J.M.).
Sabrina GrantTranslational Health Sciences, University of Bristol, United Kingdom (S. Grant).
Sheila GreenfieldFrom the Institute of Applied Health Research, University of Birmingham, United Kingdom (M.M., S.J., S. Greenfield, J.H.).
F D Richard HobbsNuffield Department of Primary Care Health Sciences, University of Oxford, United Kingdom (A.N., M.F., F.D.R.H., R.J.M.).
James HodgkinsonFrom the Institute of Applied Health Research, University of Birmingham, United Kingdom (M.M., S.J., S. Greenfield, J.H.).
Jonathan MantDepartment of Public Health and Primary Care, University of Cambridge, United Kingdom (J.M.).
Richard J McManusNuffield Department of Primary Care Health Sciences, University of Oxford, United Kingdom (A.N., M.F., F.D.R.H., R.J.M.).

Funding

Department of Health IS-SPC-0514-10043Department of Health NIHR-RP-02-12-015Department of Health RP-PG-1209-10051Medical Research Council MC_PC_11004
6 · The paper itself

Abstract

The use of self-monitoring of blood pressure, with or without telemonitoring, to guide therapy decisions by physicians for patients with hypertension has been recently demonstrated to reduce blood pressure compared with using clinic monitoring (usual care). However, both the cost-effectiveness of these strategies compared with usual care, and whether the additional benefit of telemonitoring compared with self-monitoring alone could be considered value for money, are unknown. This study assessed the cost-effectiveness of physician titration of antihypertensive medication using self-monitored blood pressure, with or without telemonitoring, to make hypertension treatment decisions in primary care compared with usual care. A Markov patient-level simulation model was developed taking a UK Health Service/Personal Social Services perspective. The model adopted a lifetime time horizon with 6-month time cycles. At a willingness to pay of £20 000 per quality-adjusted life year, self-monitoring plus telemonitoring was the most cost-effective strategy (£17 424 per quality-adjusted life year gained) compared with usual care or self-monitoring alone (posting the results to the physician). However, deterministic sensitivity analysis showed that self-monitoring alone became the most cost-effective option when changing key assumptions around long-term effectiveness and time horizon. Overall, probabilistic sensitivity analysis suggested that self-monitoring regardless of transmission modality was likely to be cost-effective compared with usual care (89% probability of cost-effectiveness at £20 000/quality-adjusted life year), with high uncertainty as to whether telemonitoring or self-monitoring alone was the most cost-effective option. Self-monitoring in clinical practice is cost-effective and likely to lead to reduced cardiovascular mortality and morbidity.

Indexed as

Antihypertensive AgentsBlood PressureBlood Pressure DeterminationCost-Benefit AnalysisHumansHypertensionModels, EconomicPrimary Health CareSelf CareTelemedicineAntihypertensive Agentsblood pressurecost-benefit analysisprobabilityself-management

Identifiers

PMID31067190
PMCPMC6510405

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.