Delivering Diabetes Education through Nurse-Led Telecoaching. Cost-Effectiveness Analysis.
BACKGROUND:People with diabetes have a high risk of developing micro- and macrovascular complications associated with diminished life expectancy and elevated treatment costs. Patient education programs can improve diabetes control in the short term, but their cost-effectiveness is uncertain. Our stu...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2016-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC5058491?pdf=render |
| _version_ | 1828300617154560000 |
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| author | Irina Odnoletkova Dirk Ramaekers Frank Nobels Geert Goderis Bert Aertgeerts Lieven Annemans |
| author_facet | Irina Odnoletkova Dirk Ramaekers Frank Nobels Geert Goderis Bert Aertgeerts Lieven Annemans |
| author_sort | Irina Odnoletkova |
| collection | DOAJ |
| description | BACKGROUND:People with diabetes have a high risk of developing micro- and macrovascular complications associated with diminished life expectancy and elevated treatment costs. Patient education programs can improve diabetes control in the short term, but their cost-effectiveness is uncertain. Our study aimed to analyze the lifelong cost-effectiveness of a nurse-led telecoaching program compared to usual care in people with type 2 diabetes from the perspective of the Belgian healthcare system. METHODS:The UKPDS Outcomes Model was populated with patient-level data from an 18-month randomized clinical trial in the Belgian primary care sector involving 574 participants; trial data were extrapolated to 40 years; Quality Adjusted Life Years (QALYs), treatment costs and Incremental Cost-Effectiveness Ratio (ICER) were calculated for the entire cohort and the subgroup with poor glycemic control at baseline ("elevated HbA1c subgroup") and the associated uncertainty was explored. RESULTS:The cumulative mean QALY (95% CI) gain was 0.21 (0.13; 0.28) overall and 0.56 (0.43; 0.68) in elevated HbA1c subgroup; the respective incremental costs were €1,147 (188; 2,107) and €2,565 (654; 4,474) and the respective ICERs €5,569 (€677; €15,679) and €4,615 (1,207; 9,969) per QALY. In the scenario analysis, repeating the intervention for lifetime had the greatest impact on the cost-effectiveness and resulted in the mean ICERs of €13,034 in the entire cohort and €7,858 in the elevated HbA1c subgroup. CONCLUSION:Taking into account reimbursement thresholds applied in West-European countries, nurse-led telecoaching of people with type 2 diabetes may be considered highly cost-effective within the Belgian healthcare system. TRIAL REGISTRATION:NCT01612520. |
| first_indexed | 2024-04-13T13:12:43Z |
| format | Article |
| id | doaj.art-4032d02972704000bb814161ab7641e6 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-13T13:12:43Z |
| publishDate | 2016-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-4032d02972704000bb814161ab7641e62022-12-22T02:45:33ZengPublic Library of Science (PLoS)PLoS ONE1932-62032016-01-011110e016399710.1371/journal.pone.0163997Delivering Diabetes Education through Nurse-Led Telecoaching. Cost-Effectiveness Analysis.Irina OdnoletkovaDirk RamaekersFrank NobelsGeert GoderisBert AertgeertsLieven AnnemansBACKGROUND:People with diabetes have a high risk of developing micro- and macrovascular complications associated with diminished life expectancy and elevated treatment costs. Patient education programs can improve diabetes control in the short term, but their cost-effectiveness is uncertain. Our study aimed to analyze the lifelong cost-effectiveness of a nurse-led telecoaching program compared to usual care in people with type 2 diabetes from the perspective of the Belgian healthcare system. METHODS:The UKPDS Outcomes Model was populated with patient-level data from an 18-month randomized clinical trial in the Belgian primary care sector involving 574 participants; trial data were extrapolated to 40 years; Quality Adjusted Life Years (QALYs), treatment costs and Incremental Cost-Effectiveness Ratio (ICER) were calculated for the entire cohort and the subgroup with poor glycemic control at baseline ("elevated HbA1c subgroup") and the associated uncertainty was explored. RESULTS:The cumulative mean QALY (95% CI) gain was 0.21 (0.13; 0.28) overall and 0.56 (0.43; 0.68) in elevated HbA1c subgroup; the respective incremental costs were €1,147 (188; 2,107) and €2,565 (654; 4,474) and the respective ICERs €5,569 (€677; €15,679) and €4,615 (1,207; 9,969) per QALY. In the scenario analysis, repeating the intervention for lifetime had the greatest impact on the cost-effectiveness and resulted in the mean ICERs of €13,034 in the entire cohort and €7,858 in the elevated HbA1c subgroup. CONCLUSION:Taking into account reimbursement thresholds applied in West-European countries, nurse-led telecoaching of people with type 2 diabetes may be considered highly cost-effective within the Belgian healthcare system. TRIAL REGISTRATION:NCT01612520.http://europepmc.org/articles/PMC5058491?pdf=render |
| spellingShingle | Irina Odnoletkova Dirk Ramaekers Frank Nobels Geert Goderis Bert Aertgeerts Lieven Annemans Delivering Diabetes Education through Nurse-Led Telecoaching. Cost-Effectiveness Analysis. PLoS ONE |
| title | Delivering Diabetes Education through Nurse-Led Telecoaching. Cost-Effectiveness Analysis. |
| title_full | Delivering Diabetes Education through Nurse-Led Telecoaching. Cost-Effectiveness Analysis. |
| title_fullStr | Delivering Diabetes Education through Nurse-Led Telecoaching. Cost-Effectiveness Analysis. |
| title_full_unstemmed | Delivering Diabetes Education through Nurse-Led Telecoaching. Cost-Effectiveness Analysis. |
| title_short | Delivering Diabetes Education through Nurse-Led Telecoaching. Cost-Effectiveness Analysis. |
| title_sort | delivering diabetes education through nurse led telecoaching cost effectiveness analysis |
| url | http://europepmc.org/articles/PMC5058491?pdf=render |
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