Assessment of remote patient monitoring (RPM) systems for patients with type 2 diabetes: a systematic review and meta-analysis

Abstract Introduction: Nowadays, an alternative model for evolution of health care is required to reduce the chronic illness burden notably diabetes; to this end, using the remote patient monitoring system is recommended. This system virtually eliminates distance barriers and constantly monitors the patients' information on urban and rural areas. Moreover, in case of trouble, patients are immediately supported and quick warnings are sent to the health care provider and the patient, if necessary. This study aimed to investigate the economic evaluation of the remote type 2 diabetes monitoring for controlling the blood glucose (glycosylated hemoglobin) compared to routine type 2 diabetes care.Methods: Economic evaluation was carried out using the finished cost of the remote type 2 diabetes monitoring technology and the routine treatment, incremental cost-effectiveness ratio as well as one-way and multiple sensitivity analysis using the key variables such as population, cost items, the minimum, maximum and average population size. In this study, the remote type 2 diabetes monitoring technology was compared with the routine treatment.Results: The results showed that, considering the incremental cost-effectiveness ratio in the base model, the remote type 2 diabetes monitoring system in comparison with routine treatment of type 2 diabetes was placed in the second quarter (more effective and affordable technology) of the graph as the most dominant alternative. The results of the two-way sensitivity analysis revealed that the research findings are consistent in terms of cost and population variables and in all cases were included in the second quarter (more effective and affordable technology) in the incremental cost-effectiveness ratio graph and were dominant compared to the routine treatment.Conclusion: Remote patient monitoring is a dominant alternative compared to routine treatment. Further evidence on long-term remote patient monitoring experience is needed for future studies. Results indicated that remote type 2 diabetes monitoring interventions play an effective role in reducing HbA1c that may be considered the rationale for policy makers on domestication of this technology.

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Cost analysis of a remote patient monitoring programme for post-discharge patients with type 2 diabetes

Journal of Telemedicine and Telecare ◽

10.1177/1357633x20985393 ◽

2021 ◽

pp. 1357633X2098539

Author(s):

Tzeyu L Michaud ◽

Jennie L Hill ◽

Paul A Estabrooks ◽

Dejun Su

Keyword(s):

Type 2 Diabetes ◽

Cost Analysis ◽

Patient Monitoring ◽

Diabetes Management ◽

Economic Feasibility ◽

Remote Patient Monitoring ◽

Post Discharge ◽

Scenario Analyses ◽

Remote Patient

Introduction Assessing costs of an evidence-based health promotion programme is crucial to understand the economic feasibility of adopting or sustaining the programme. This study conducted a cost analysis of a remote patient monitoring (RPM) programme to enhance the post-discharge management of type 2 diabetes. Methods Using retrospective data collected during RPM implementation from September 2014 to February 2018, we estimated the costs of implementing an RPM in the primary care setting. Measures included total and average annual costs, costs per participant who was enrolled or completed the programme, and costs per person-day. We further conducted sensitivity and scenario analyses to examine variations in estimated programme costs associated with varying programme efficiencies and alternative personnel compositions of the RPM team. Results The total RPM implementation costs were estimated at US$4,374,544 with an average annual programme costs of US$1,249,870, which translated to US$3207 per participant ( n = 1364) completing the three-month programme. The per person-day cost was averaged at US$24 (182,932 person-days). Sensitivity and scenario analyses results indicate that the sustainment costs were approximately US$1.6 million annually and the per-person-day costs were between US$21 and US$29 with each nurse coach on average serving a panel of 62–93 patients. Conclusion The implementation and sustainment costs of an RPM programme, estimated under various assumptions of programme efficiency and care team compositions, as exemplified in this study, will help healthcare organizations make informed decisions in budgeting for and sustaining telehealth programmes to enhance diabetes management.

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