Cargando…

The cost-effectiveness of hospital-based telephone coaching for people with type 2 diabetes: a 10 year modelling analysis

BACKGROUND: Type 2 diabetes (T2DM) is a burdensome condition for individuals to live with and an increasingly costly condition for health services to treat. Cost-effective treatment strategies are required to delay the onset and slow the progression of diabetes related complications. The Diabetes Te...

Descripción completa

Detalles Bibliográficos
Autores principales: Varney, J. E., Liew, D., Weiland, T. J., Inder, W. J., Jelinek, G. A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5039787/
https://www.ncbi.nlm.nih.gov/pubmed/27678079
http://dx.doi.org/10.1186/s12913-016-1645-6
_version_ 1782456130314698752
author Varney, J. E.
Liew, D.
Weiland, T. J.
Inder, W. J.
Jelinek, G. A.
author_facet Varney, J. E.
Liew, D.
Weiland, T. J.
Inder, W. J.
Jelinek, G. A.
author_sort Varney, J. E.
collection PubMed
description BACKGROUND: Type 2 diabetes (T2DM) is a burdensome condition for individuals to live with and an increasingly costly condition for health services to treat. Cost-effective treatment strategies are required to delay the onset and slow the progression of diabetes related complications. The Diabetes Telephone Coaching Study (DTCS) demonstrated that telephone coaching is an intervention that may improve the risk factor status and diabetes management practices of people with T2DM. Measuring the cost effectiveness of this intervention is important to inform funding decisions that may facilitate the translation of this research into clinical practice. The purpose of this study is to assess the cost-effectiveness of telephone coaching, compared to usual diabetes care, in participants with poorly controlled T2DM. METHODS: A cost utility analysis was undertaken using the United Kingdom Prospective Diabetes Study (UKPDS) Outcomes Model to extrapolate outcomes collected at 6 months in the DTCS over a 10 year time horizon. The intervention’s impact on life expectancy, quality-adjusted life expectancy (QALE) and costs was estimated. Costs were reported from a health system perspective. A 5 % discount rate was applied to all future costs and effects. One-way sensitivity analyses were conducted to reflect uncertainty surrounding key input parameters. RESULTS: The intervention dominated the control condition in the base-case analysis, contributing to cost savings of $3327 per participant, along with non-significant improvements in QALE (0.2 QALE) and life expectancy (0.3 years). CONCLUSIONS: The cost of delivering the telephone coaching intervention continuously, for 10 years, was fully recovered through cost savings and a trend towards net health benefits. Findings of cost savings and net health benefits are rare and should prove attractive to decision makers who will determine whether this intervention is implemented into clinical practice. TRIAL REGISTRATION: ACTRN12609000075280 ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12913-016-1645-6) contains supplementary material, which is available to authorized users.
format Online
Article
Text
id pubmed-5039787
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-50397872016-10-05 The cost-effectiveness of hospital-based telephone coaching for people with type 2 diabetes: a 10 year modelling analysis Varney, J. E. Liew, D. Weiland, T. J. Inder, W. J. Jelinek, G. A. BMC Health Serv Res Research Article BACKGROUND: Type 2 diabetes (T2DM) is a burdensome condition for individuals to live with and an increasingly costly condition for health services to treat. Cost-effective treatment strategies are required to delay the onset and slow the progression of diabetes related complications. The Diabetes Telephone Coaching Study (DTCS) demonstrated that telephone coaching is an intervention that may improve the risk factor status and diabetes management practices of people with T2DM. Measuring the cost effectiveness of this intervention is important to inform funding decisions that may facilitate the translation of this research into clinical practice. The purpose of this study is to assess the cost-effectiveness of telephone coaching, compared to usual diabetes care, in participants with poorly controlled T2DM. METHODS: A cost utility analysis was undertaken using the United Kingdom Prospective Diabetes Study (UKPDS) Outcomes Model to extrapolate outcomes collected at 6 months in the DTCS over a 10 year time horizon. The intervention’s impact on life expectancy, quality-adjusted life expectancy (QALE) and costs was estimated. Costs were reported from a health system perspective. A 5 % discount rate was applied to all future costs and effects. One-way sensitivity analyses were conducted to reflect uncertainty surrounding key input parameters. RESULTS: The intervention dominated the control condition in the base-case analysis, contributing to cost savings of $3327 per participant, along with non-significant improvements in QALE (0.2 QALE) and life expectancy (0.3 years). CONCLUSIONS: The cost of delivering the telephone coaching intervention continuously, for 10 years, was fully recovered through cost savings and a trend towards net health benefits. Findings of cost savings and net health benefits are rare and should prove attractive to decision makers who will determine whether this intervention is implemented into clinical practice. TRIAL REGISTRATION: ACTRN12609000075280 ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12913-016-1645-6) contains supplementary material, which is available to authorized users. BioMed Central 2016-09-27 /pmc/articles/PMC5039787/ /pubmed/27678079 http://dx.doi.org/10.1186/s12913-016-1645-6 Text en © Varney et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Varney, J. E.
Liew, D.
Weiland, T. J.
Inder, W. J.
Jelinek, G. A.
The cost-effectiveness of hospital-based telephone coaching for people with type 2 diabetes: a 10 year modelling analysis
title The cost-effectiveness of hospital-based telephone coaching for people with type 2 diabetes: a 10 year modelling analysis
title_full The cost-effectiveness of hospital-based telephone coaching for people with type 2 diabetes: a 10 year modelling analysis
title_fullStr The cost-effectiveness of hospital-based telephone coaching for people with type 2 diabetes: a 10 year modelling analysis
title_full_unstemmed The cost-effectiveness of hospital-based telephone coaching for people with type 2 diabetes: a 10 year modelling analysis
title_short The cost-effectiveness of hospital-based telephone coaching for people with type 2 diabetes: a 10 year modelling analysis
title_sort cost-effectiveness of hospital-based telephone coaching for people with type 2 diabetes: a 10 year modelling analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5039787/
https://www.ncbi.nlm.nih.gov/pubmed/27678079
http://dx.doi.org/10.1186/s12913-016-1645-6
work_keys_str_mv AT varneyje thecosteffectivenessofhospitalbasedtelephonecoachingforpeoplewithtype2diabetesa10yearmodellinganalysis
AT liewd thecosteffectivenessofhospitalbasedtelephonecoachingforpeoplewithtype2diabetesa10yearmodellinganalysis
AT weilandtj thecosteffectivenessofhospitalbasedtelephonecoachingforpeoplewithtype2diabetesa10yearmodellinganalysis
AT inderwj thecosteffectivenessofhospitalbasedtelephonecoachingforpeoplewithtype2diabetesa10yearmodellinganalysis
AT jelinekga thecosteffectivenessofhospitalbasedtelephonecoachingforpeoplewithtype2diabetesa10yearmodellinganalysis
AT varneyje costeffectivenessofhospitalbasedtelephonecoachingforpeoplewithtype2diabetesa10yearmodellinganalysis
AT liewd costeffectivenessofhospitalbasedtelephonecoachingforpeoplewithtype2diabetesa10yearmodellinganalysis
AT weilandtj costeffectivenessofhospitalbasedtelephonecoachingforpeoplewithtype2diabetesa10yearmodellinganalysis
AT inderwj costeffectivenessofhospitalbasedtelephonecoachingforpeoplewithtype2diabetesa10yearmodellinganalysis
AT jelinekga costeffectivenessofhospitalbasedtelephonecoachingforpeoplewithtype2diabetesa10yearmodellinganalysis