A cost-effectiveness evaluation of a dietitian-delivered telephone coaching program during pregnancy for preventing gestational diabetes mellitus
Abstract Background This study aimed to evaluate the cost-effectiveness of a telehealth coaching intervention to prevent gestational diabetes mellitus (GDM) and to calculate the breakeven point of preventing GDM. Methods Data to inform the economic evaluation model was sourced directly from the larg...
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| Format: | Article |
| Language: | English |
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BMC
2024-03-01
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| Series: | Cost Effectiveness and Resource Allocation |
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| Online Access: | https://doi.org/10.1186/s12962-024-00520-9 |
| _version_ | 1797274454948052992 |
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| author | Susan de Jersey Syed Afroz Keramat Angela Chang Nina Meloncelli Taylor Guthrie Elizabeth Eakin Tracy Comans |
| author_facet | Susan de Jersey Syed Afroz Keramat Angela Chang Nina Meloncelli Taylor Guthrie Elizabeth Eakin Tracy Comans |
| author_sort | Susan de Jersey |
| collection | DOAJ |
| description | Abstract Background This study aimed to evaluate the cost-effectiveness of a telehealth coaching intervention to prevent gestational diabetes mellitus (GDM) and to calculate the breakeven point of preventing GDM. Methods Data to inform the economic evaluation model was sourced directly from the large quaternary hospital in Brisbane, where the Living Well during Pregnancy (LWdP) program was implemented, and further supplemented with literature-based estimates where data had not been directly collected in the trial. A cost-effectiveness model was developed using a decision tree framework to estimate the potential for cost savings and quality of life improvement. A total of 1,315 pregnant women (49% with a BMI 25-29.9, and 51% with a BMI ≥ 30) were included in the analyses. Results The costs of providing routine care and routine care plus LWdP coaching intervention to pregnant women were calculated to be AUD 20,933 and AUD 20,828, respectively. The effectiveness of the LWdP coaching program (0.894 utility) was slightly higher compared to routine care (0.893). Therefore, the value of the incremental cost-effectiveness ratio (ICER) was negative, and it indicates that the LWdP coaching program is a dominant strategy to prevent GDM in pregnant women. We also performed a probabilistic sensitivity analysis using Monte Carlo simulation through 1,000 simulations. The ICE scatter plot showed that the LWdP coaching intervention was dominant over routine care in 93.60% of the trials using a willingness to pay threshold of AUD 50,000. Conclusion Findings support consideration by healthcare policy and decision makers of telehealth and broad-reach delivery of structured lifestyle interventions during pregnancy to lower short-term costs associated with GDM to the health system. |
| first_indexed | 2024-03-07T14:58:36Z |
| format | Article |
| id | doaj.art-9761903562374d679d35cfc4f1afe0aa |
| institution | Directory Open Access Journal |
| issn | 1478-7547 |
| language | English |
| last_indexed | 2024-03-07T14:58:36Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Cost Effectiveness and Resource Allocation |
| spelling | doaj.art-9761903562374d679d35cfc4f1afe0aa2024-03-05T19:15:48ZengBMCCost Effectiveness and Resource Allocation1478-75472024-03-012211910.1186/s12962-024-00520-9A cost-effectiveness evaluation of a dietitian-delivered telephone coaching program during pregnancy for preventing gestational diabetes mellitusSusan de Jersey0Syed Afroz Keramat1Angela Chang2Nina Meloncelli3Taylor Guthrie4Elizabeth Eakin5Tracy Comans6Department of Dietetics and Food Services, Royal Brisbane and Women’s Hospital, Metro North HealthCentre for Health Services Research, Faculty of Medicine, The University of QueenslandCentre for Allied Health Research, Royal Brisbane and Women’s Hospital, Metro North HealthCentre for Health Services Research, Faculty of Medicine, The University of QueenslandDepartment of Dietetics and Food Services, Royal Brisbane and Women’s Hospital, Metro North HealthSchool of Public Health, Faculty of Medicine, The University of QueenslandCentre for Health Services Research, Faculty of Medicine, The University of QueenslandAbstract Background This study aimed to evaluate the cost-effectiveness of a telehealth coaching intervention to prevent gestational diabetes mellitus (GDM) and to calculate the breakeven point of preventing GDM. Methods Data to inform the economic evaluation model was sourced directly from the large quaternary hospital in Brisbane, where the Living Well during Pregnancy (LWdP) program was implemented, and further supplemented with literature-based estimates where data had not been directly collected in the trial. A cost-effectiveness model was developed using a decision tree framework to estimate the potential for cost savings and quality of life improvement. A total of 1,315 pregnant women (49% with a BMI 25-29.9, and 51% with a BMI ≥ 30) were included in the analyses. Results The costs of providing routine care and routine care plus LWdP coaching intervention to pregnant women were calculated to be AUD 20,933 and AUD 20,828, respectively. The effectiveness of the LWdP coaching program (0.894 utility) was slightly higher compared to routine care (0.893). Therefore, the value of the incremental cost-effectiveness ratio (ICER) was negative, and it indicates that the LWdP coaching program is a dominant strategy to prevent GDM in pregnant women. We also performed a probabilistic sensitivity analysis using Monte Carlo simulation through 1,000 simulations. The ICE scatter plot showed that the LWdP coaching intervention was dominant over routine care in 93.60% of the trials using a willingness to pay threshold of AUD 50,000. Conclusion Findings support consideration by healthcare policy and decision makers of telehealth and broad-reach delivery of structured lifestyle interventions during pregnancy to lower short-term costs associated with GDM to the health system.https://doi.org/10.1186/s12962-024-00520-9GDMPreventionCost-effectivenessNutrition |
| spellingShingle | Susan de Jersey Syed Afroz Keramat Angela Chang Nina Meloncelli Taylor Guthrie Elizabeth Eakin Tracy Comans A cost-effectiveness evaluation of a dietitian-delivered telephone coaching program during pregnancy for preventing gestational diabetes mellitus Cost Effectiveness and Resource Allocation GDM Prevention Cost-effectiveness Nutrition |
| title | A cost-effectiveness evaluation of a dietitian-delivered telephone coaching program during pregnancy for preventing gestational diabetes mellitus |
| title_full | A cost-effectiveness evaluation of a dietitian-delivered telephone coaching program during pregnancy for preventing gestational diabetes mellitus |
| title_fullStr | A cost-effectiveness evaluation of a dietitian-delivered telephone coaching program during pregnancy for preventing gestational diabetes mellitus |
| title_full_unstemmed | A cost-effectiveness evaluation of a dietitian-delivered telephone coaching program during pregnancy for preventing gestational diabetes mellitus |
| title_short | A cost-effectiveness evaluation of a dietitian-delivered telephone coaching program during pregnancy for preventing gestational diabetes mellitus |
| title_sort | cost effectiveness evaluation of a dietitian delivered telephone coaching program during pregnancy for preventing gestational diabetes mellitus |
| topic | GDM Prevention Cost-effectiveness Nutrition |
| url | https://doi.org/10.1186/s12962-024-00520-9 |
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