NICE backs 'cost-saving' ambulatory monitoring for diagnosing hypertension

Updated NICE BP guidance recommending ambulatory monitoring before diagnosing primary hypertension will save the NHS millions of pounds, NICE believes.

NICE guidlines on ambulatory monitoring will lower the risk of overdiagnosis and so reduce GP workload and prescribing costs (Photograph: SPL)
NICE guidlines on ambulatory monitoring will lower the risk of overdiagnosis and so reduce GP workload and prescribing costs (Photograph: SPL)

In updated guidelines, NICE recommends that a diagnosis of primary hypertension should be confirmed using 24-hour ambulatory BP monitoring.

The new diagnostic criteria will lower the risk of overdiagnosis and so reduce GP workload and prescribing costs. A costing analysis presented alongside the guideline and published in The Lancet suggests that that the diagnostic criteria would be cost-saving within a year.

Within five years, a practice with 10,000 patients would save £2,000 a year and the NHS in England would be saving £10m a year, the analysis suggests.

Savings have been estimated based on a cost of £1,000 per ambulatory monitor. However, NICE expects prices of these devices to roughly halve as their use becomes more widespread.

Professor Bryan Williams of the University of Leicester, who helped developed the guidelines, said he expected that in some areas consortia, rather than practices, would buy ambulatory monitors.

NICE does not expect the guidelines to be followed immediately, but said it would expect the new recommendations to implemented within 'the next year or so'.

The revised recommendations contain no major changes to the treatment thresholds and targets, but the treatment algorithm has been simplified.

Birmingham GP Professor Richard McManus, who is professor of primary care cardiovascular research at University of Birmingham, also helped developed the guidelines. He said the guidelines marked ‘a significant change’ in the hypertension is diagnosed.

‘The use of ambulatory monitoring will ensure quicker and more accurate diagnosis that will be better for patients and better for the NHS,’ he said. ‘This represents an exciting advance which I am sure will be taken up internationally.’

The guidelines recommend a calcium channel blocker as the first pharmacological agent for patients aged over 55 years or of African or Caribbean family origin and an ACE inhibitor or angiotensin II receptor blocker (ARB) for patients under 55 years.

The updated recommendations, 'Clinical management of primary hypertension in adults', are available on the NICE website and replace NICE clinical guideline 34.

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Register

Already registered?

Sign in

Follow Us:

Just published

Practices handed one-month opt-out window as revamped network DES unveiled

Practices handed one-month opt-out window as revamped network DES unveiled

NHS England has unveiled a revamped DES package for 2020/21 confirming new targets,...

GPs delivered huge rise in face-to-face consultations in week before NHS England letter

GPs delivered huge rise in face-to-face consultations in week before NHS England letter

GPs delivered a huge increase in face-to-face appointments in the week before NHS...

RCGP facing legal action over stance on assisted dying

RCGP facing legal action over stance on assisted dying

The RCGP is facing legal action over its decision to remain opposed to assisted dying...

Medeconomics Live aims to help practices thrive under the new GP contract

Medeconomics Live aims to help practices thrive under the new GP contract

The one-day, virtual Medeconomics Live conference aims to provide practices with...

GPs face wave of abuse and complaints after NHS England face-to-face appointments claims

GPs face wave of abuse and complaints after NHS England face-to-face appointments claims

GP practices have faced a wave of abuse and complaints after a letter from NHS England...

Government denies plan to make GPs 'gatekeepers' of COVID-19 testing

Government denies plan to make GPs 'gatekeepers' of COVID-19 testing

The government has denied plans to make GPs 'gatekeepers' of the struggling COVID-19...