The cost-effectiveness of peer education on medication adherence in the elderly with hypertension: a randomized controlled trial
Open accessAbstract
BACKGROUND: Peer education is an effective approach for promoting medication adherence in hypertensive patients, but there is limited evidence on its cost-effectiveness analysis. This study aimed to evaluate the cost -effectiveness of peer education for improving medication adherence in the elderly with hypertension. METHODS: This randomized clinical trial involved 74 elderly individuals with hypertension who were referred to health centers affiliated to Mashhad University of Medical Sciences in 2019. Educational content was presented over six sessions across six weeks by a peer in the intervention group, and a health center nurse in the control group. Data was collected before the intervention, immediately after intervention, and at 3 and 6 weeks post-intervention using the Morisky Medication Adherence Scale. Data analysis was performed by SPSS (Ver. 23) with both descriptive and statistical test. Cost-effectiveness analysis of the educational methods measured the impact on medication adherence scores for each group. RESULTS: The medication adherence score was 7.33 ± 0.41 and 6.37 ± 0.76 at 6 weeks post educational sessions in the intervention and control groups, respectively. There was a significant difference in mean score of medication adherence at the end of the intervention, as well as at 3 and 6 weeks post-intervention between the groups (p < 0.001). Additionally, the results indicated that peer education approach was more cost-effective than routine education. CONCLUSIONS: Peer education programs promote medication adherence in elderly with hypertension and are more cost-effective than routine education in health centers. Healthcare managers can improve medication adherence and reduce costs with employing peers to educate older individuals with hypertension. TRIAL REGISTRATION: This study was registered in the Iranian Registry of Clinical Trials (registration number: IRCT20180519039710N1). Registration date: July 29, 2018.
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Ranjbar et al. reported 30% cost savings with peer education over nurse-led programs.
“Ranjbar et al. reported a 20% adherence gain and 30% cost savings with peer education over nurse-led programs [19].”
From Multilevel Interventions to Improve Medication Adherence in Older Adults: A Systematic Review and Meta-Analysis of Cognitive, Digital, Behavioral, and Socioeconomic Strategies (2015–2025) (2026) · cites this paper as [19]
The Discussion reports that peer education was more cost-effective than routine training by a health-center nurse. It does not report 30% cost savings. Results Table 4 instead lists higher total implementation costs for peer education (9,960,000 Rials) than for the control group (7,800,000 Rials); the savings discussed in the Results concern cost per unit of adherence improvement. (LLM, conf=0.88)
Experimental — accuracy not yet measuredRanjbar et al. reported a 20% adherence gain with peer education over nurse-led programs.
“Ranjbar et al. reported a 20% adherence gain and 30% cost savings with peer education over nurse-led programs [19].”
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- Authors
- Ranjbar, H., Sadeghi-Vazin, K., & Bakhshi, M.
- Affiliations
- Torbat Heydarieh University of Medical Sciences (IR)
- Mashhad University of Medical Sciences (IR)
- Corresponding author
- Bakhshi, Mahmoud
- Venue
- BMC Public Health
- Published
- 2024-11-25
- Volume
- 24
- Issue
- 1
- Pages
- 3268-3268
- ISSN
- 1471-2458 (ISSN-L)
- PMC
- PMC11587726
- OpenAlex
- W4404701159
- Cited by
- 8
- References
- 26
- Citations by year
- 2026: 4 · 2025: 4
- FWCI
- 4.44
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Public Health (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Mashhad University of Medical Sciences
- Topics
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacy and Medical Practices
- Keywords
- peer education, medication adherence, hypertension, older adults, cost-effectiveness, health education, nurse-led education, Morisky Medication Adherence Scale
- MeSH terms
- Assessment of Medication Adherence, Aged, Aged, 80 and over, Antihypertensive Agents, Cost-Benefit Analysis, Female, Humans, Hypertension, Iran, Male, Middle Aged, Patient Education as Topic, Peer Group, Drug Monitoring, Medication Adherence
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