J Vis Exp. 2026 Jul 31;(233). doi: 10.3791/72056.
ABSTRACT
This study evaluated the effectiveness and cost-effectiveness of Internet-based pharmaceutical care (IPC) incorporating patient-reported outcomes (PROs) in postoperative patients with pulmonary arterial hypertension associated with congenital heart disease (PAH-CHD). A cohort study was conducted at Fuwai Yunnan Hospital between July 2018 and June 2025. Patients received IPC interventions consisting of WeChat-based health education and PRO assessments using the EuroQol EQ-5D-3L and medication compliance questionnaires. A Markov cohort model with a 26-cycle (52-year) horizon was applied to assess the long-term economic value of IPC-PROs. A total of 657 PAH-CHD patients were enrolled, including 422 patients in the IPC group and 235 in the control group. At 90 days post-surgery, the mean pulmonary arterial pressure in the IPC group was significantly lower than that in the control group (33.07 ± 21.62 mmHg vs. 50.17 ± 26.35 mmHg, p. < 0.05). The postoperative health utility improved from 0.6762 to 0.9770 following IPC intervention, while medication compliance scores remained near-perfect throughout the 24-month follow-up period. The Markov cohort simulation demonstrated that the IPC group achieved a gain of 17.0 quality-adjusted life years (QALYs) at a cost of ¥156.87 per patient, resulting in an incremental cost-effectiveness ratio (ICER) of ¥184.11/QALY, which was substantially below the willingness-to-pay threshold of ¥202,800. These findings indicate that IPC integrated with PROs is an effective and cost-effective strategy for improving postoperative outcomes in PAH-CHD patients in Yunnan Province, China.
PMID:42612115 | DOI:10.3791/72056