OP348 Assessing The Potential Value Of Wearable Digital Health Technologies In Chronic Kidney Disease Using Early Health Technology Assessment Methods

2021 ◽  
Vol 37 (S1) ◽  
pp. 15-16
Author(s):  
Vijay S. Gc ◽  
Andrea Manca ◽  
Alexander J. Casson ◽  
Steven Antrobus ◽  
Cynthia Iglesias
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Digital Health ◽  
Qualitative Interviews ◽  
Cost Effective ◽  
Health Technology ◽  
Self Management ◽  
Health Technologies ◽  
Early Health Technology Assessment ◽  
Early Health

IntroductionWearable digital health technologies (WDHTs) offer several solutions in terms of disease monitoring, management and delivery of specific interventions. In chronic conditions, WDHTs can be used to support individuals’ self-management efforts, potentially improving adherence to (and outcomes resulting from) interventions. Early health technology assessment (HTA) methods can inform considerations about the potential clinical and economic benefits of technology in the initial phases of the product's lifecycle, facilitating identification of those Research & Development (R&D) investments with the greatest potential stakeholders’ payoff. We report our experience of using early HTA methods to support R&D decisions relating to novel WDHT being designed to support self-management of chronic kidney disease (CKD).MethodsWe performed a literature review, focus-group interviews with patients, and qualitative interviews with the prototype development team to understand the relevant characteristics of WDHTs, quantify relevant clinical indications and existing technological constraints. An early economic evaluation was used to identify the key drivers of value for money, and a discrete choice experiment shed light onto patient preferences towards what key features the WDHT should have for the users to adopt it. Then a model-based cost-effectiveness analysis was undertaken incorporating headroom analysis, return on investment, one-way sensitivity analysis and scenario analyses using data from secondary sources.ResultsThe review of the literature, focus groups with CKD patients, and qualitative interviews with technology developers helped to understand relevant characteristics of WDHT and user preferences helped inform the next R&D iteration. Compared to the standard care, WDHT that support stage ≥3 CKD patients self-management at home by measuring blood pressure and monitor mobility has the potential to be cost-effective at conventional cost-effectiveness threshold levels. From the headroom analysis, novel WDHT can be priced up to GBP280 (EUR315, USD360) and still be cost-effective compared to standard home blood pressure monitoring.ConclusionsOur study provides valuable information for the further development of the WDHT, such as defining a go/no-go decision, as well as providing a template for performing early HTA of Digital Health Interventions.

OP73 Problems And Promises Of Health Technologies: The Merits Of Early Health Technology Assessment

2018 ◽  
Vol 34 (S1) ◽  
pp. 26-27
Author(s):  
Janneke Grutters ◽  
Tim Govers ◽  
Jorte Nijboer ◽  
Gert Jan van der Wilt ◽  
Jan Rongen ◽  
...  
Keyword(s):  
Care Pathway ◽  
Target Population ◽  
Health Technology ◽  
Health Technologies ◽  
Early Health Technology Assessment ◽  
Secondary Analyses ◽  
Early Health ◽  
Adoption Decisions ◽  
Assessment Decisions ◽  
Further Development

Introduction:Novel health technologies are being developed at a dizzying pace. The need to avoid unnecessary innovations and accelerate the adoption of valuable innovations is among the most important challenges facing healthcare systems today. To contribute to this challenge, we performed 30 so-called ‘early health technology assessments’ (HTA) over the last three years. We quantified the potential value, both in effects and cost. We will present our experience with performing these constructive assessments, as well as their feasibility and value in informing decisions.Methods:We performed secondary analyses on an existing database of 30 assessments. We analyzed the phase of development, stakeholders involved, type of decision informed, and the technology's next steps.Results:Out of the 30 technologies, four (13 percent) were in the idea screening phase, and had not yet started the development. Here, the room for improvement (headroom) was assessed. For 16 (53 percent) technologies that were under development but not yet studied, we performed headroom and threshold analyses. For the 10 (33 percent) developed technologies where some (pilot) data were already available, scenario and/or cost-effectiveness analyses were performed. The assessments, that were commissioned by developers, clinicians or hospital managers informed evidence-based decisions on (further) development, focus, research design or adoption in clinical practice. Preliminary results suggest that after the assessment, decisions were made to stop further development (n=2), continue outside healthcare (n=1), change the target population (n=3) or change the proposed positioning in the care pathway and/or value proposition (n=4).Conclusions:Stakeholders deemed an early, formative assessment useful in informing development, research and adoption decisions, in different stages of development. Even before developing a technology, headroom analyses appeared to be feasible and useful. Consequences of the assessments mostly related to a shift in focus, which may result in more efficient research and development, as well as more valuable innovations.

OP340 Kidney Patients’ Preferences For A Wearable Digital Health Technology To Support Self-Management Of Chronic Kidney Disease - A Discrete Choice Experiment

2021 ◽  
Vol 37 (S1) ◽  
pp. 14-15
Author(s):  
Vijay S. Gc ◽  
Cynthia Iglesias ◽  
Seda Erdem ◽  
Lamiece Hassan ◽  
Andrea Manca
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Discrete Choice ◽  
Latent Class ◽  
Digital Health ◽  
Latent Class Models ◽  
User Preferences ◽  
Discrete Choice Experiments ◽  
Self Management ◽  
Health Technologies

IntroductionWearable Digital Health Technologies (WDHTs) can support and enhance self-management by giving individuals with chronic conditions more control over their health, safety and wellbeing. Involving patients early on in the design of these technologies facilitates the development of person-centered products. It may increase the potential uptake of (and adherence to) any intervention they are designed to deliver. This research aims to elicit chronic kidney disease (CKD) patients’ preferences for WDHTs that may help patients manage their conditions.MethodsWe used discrete choice experiments (DCE) to elicit preferences for WDHTs characterized by their generalizable characteristics. The study design was informed by a multi-stage mixed-method approach (MSMMA). This included a review of the published literature, focus group interviews and one-to-one interactions with CKD patients to identify relevant characteristics (that is, attributes and levels) associated with wearable DHTs. We collected the data from 113 patients (age ≥18 years) with stage 3 or above CKD. The analysis started with a conventional multinomial logit model and was extended by investigating heterogeneity in preferences via latent class models.ResultsOur MSMMA yielded ten potential attributes for consideration in a choice task. The final list included five attributes, cross-checked and validated by the research team, and patient representatives. The most preferred attributes of WDHTs were device appearance, format and type of information provided, and mode of engagement with patients. Respondents preferred a discreet device, which offered options that individuals could choose from and provided medical information.ConclusionsWe show how to use MSMMA to elicit user preferences in (and to inform the) early stages of the development of WDHTs. Individuals with CKD preferred specific characteristics that would make them more likely to engage with the self-management support WDHT. Our results provide valuable insights that can be used to inform the development of different WDHTs for different segments of the CKD patients population, moving away from a one-size-fits-all provision and resulting in population health gains.

scholarly journals The Potential Impact of Digital Biomarkers in Multiple Sclerosis in the Netherlands: An Early Health Technology Assessment of MS Sherpa

2021 ◽  
Vol 11 (10) ◽  
pp. 1305
Author(s):  
Sonja Cloosterman ◽  
Inez Wijnands ◽  
Simone Huygens ◽  
Valérie Wester ◽  
Ka-Hoo Lam ◽  
...  
Keyword(s):  
Cost Effective ◽  
Health Technology ◽  
Added Value ◽  
Early Health Technology Assessment ◽  
Early Health ◽  
Treatment Switch ◽  
Potential Impact ◽  
Digital Biomarkers ◽  
Care Path ◽  
Active Disease

(1) Background: Monitoring of Multiple Sclerosis (MS) with eHealth interventions or digital biomarkers provides added value to the current care path. Evidence in the literature is currently scarce. MS sherpa is an eHealth intervention with digital biomarkers, aimed at monitoring symptom progression and disease activity. To show the added value of digital biomarker–based eHealth interventions to the MS care path, an early Health Technology Assessment (eHTA) was performed, with MS sherpa as an example, to assess the potential impact on treatment switches. (2) Methods: The eHTA was performed according to the Dutch guidelines for health economic evaluations. A decision analytic MS model was used to estimate the costs and benefits of MS standard care with and without use of MS sherpa, expressed in incremental cost-effectiveness ratios (ICERs) from both societal and health care perspectives. The efficacy of MS sherpa on early detection of active disease and the initiation of a treatment switch were modeled for a range of assumed efficacy (5%, 10%, 15%, 20%). (3) Results: From a societal perspective, for the efficacy of 15% or 20%, MS sherpa became dominant, which means cost-saving compared to the standard of care. MS sherpa is cost-effective in the 5% and 10% scenarios (ICERs EUR 14,535 and EUR 4069, respectively). From the health care perspective, all scenarios were cost-effective. Sensitivity analysis showed that increasing the efficacy of MS sherpa in detecting active disease early leading to treatment switches be the most impactful factor in the MS model. (4) Conclusions: The results indicate the potential of eHealth interventions to be cost-effective or even cost-saving in the MS care path. As such, digital biomarker–based eHealth interventions, like MS sherpa, are promising cost-effective solutions in optimizing MS disease management for people with MS, by detecting active disease early and helping neurologists in decisions on treatment switch.

scholarly journals Evaluating the potential costs and impact of digital health technologies for tuberculosis treatment support

2018 ◽  
Vol 52 (5) ◽  
pp. 1801363 ◽  
Author(s):  
Ntwali Placide Nsengiyumva ◽  
Benjamin Mappin-Kasirer ◽  
Olivia Oxlade ◽  
Mayara Bastos ◽  
Anete Trajman ◽  
...  
Keyword(s):  
Digital Health ◽  
Cost Savings ◽  
Cost Effective ◽  
Multidrug Resistant ◽  
Potential Cost ◽  
Health Technologies ◽  
Life Years ◽  
Message Service ◽  
Latent Tb ◽  
Latent Tb Infection

Ensuring adherence and support during treatment of tuberculosis (TB) is a major public health challenge. Digital health technologies could help improve treatment outcomes. We considered their potential cost and impact on treatment for active or latent TB in Brazil.Decision analysis models simulated two adult cohorts with 1) drug-susceptible active TB, and 2) multidrug-resistant TB, and two cohorts treated with isoniazid for latent TB infection (LTBI): 1) close contacts of persons with active TB, and 2) others newly diagnosed with LTBI. We evaluated four digital support strategies: two different medication monitors, synchronous video-observed therapy (VOT), and two-way short message service (SMS). Comparators were standard directly observed treatment for active TB and self-administered treatment for LTBI. Projected outcomes included costs (2016 US dollars), plus active TB cases and disability-adjusted life years averted among persons with LTBI.For individuals with active TB, medication monitors and VOT are projected to lead to substantial (up to 58%) cost savings, in addition to alleviating inconvenience and cost to patients of supervised treatment visits. For LTBI treatment, SMS and medication monitors are projected to be the most cost-effective interventions. However, all projections are limited by the scarcity of published estimates of clinical effect for the digital technologies.

Digital health technologies for long term self-management of osteoporosis: a systematic review and meta-analysis (Preprint)

2021 ◽  
Author(s):  
Ghada Alhussein ◽  
Leontios Hadjileontiadis
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Digital Health ◽  
Meta Analysis ◽  
Self Management ◽  
Current Status ◽  
Future Research ◽  
Common Chronic Disease ◽  
Health Technologies ◽  
Management Interventions

BACKGROUND Osteoporosis is the fourth most common chronic disease in the world. Adopting preventative measures and effective self-management interventions help in improving bone health. Mobile health (mHealth) technologies can play a key role in osteoporosis patient care and self- management. OBJECTIVE This study presents a systematic review and meta-analysis of the currently available mHealth applications targeting osteoporosis self-management, aiming to determine the current status, gaps and challenges the future research could address, proposing appropriate recommendations. METHODS In this systematic review and meta-analysis, we searched PubMed, Scopus, EBSCO, Web of Science, and IEEExplore databases between Jan 1, 2010 and May 31, 2021, for all English publications that describe apps dedicated to or being useful for osteoporosis, targeting self-management, nutrition, physical activity, risk assessment, delivered on smartphone devices for young and older adults. In addition, a survey of all osteoporosis-related apps available in iOS and Android app stores as of May 31, 2021 was also conducted. Primary outcomes of interest were the prevention or reduction of unhealthy behaviours or improvement in healthy behaviours of the six behaviours. Outcomes were summarised in a narrative synthesis and combined using random-effects meta-analysis. RESULTS In total, 3906 unique articles were identified. Of these, 32 articles met the inclusion criteria and were reviewed in depth. The 32 studies were comprising 14 235 participants, of whom on average 69.5% were female, with a mean age of 49.8 years (SD 17.8). The app search identified 23 relevant apps for osteoporosis self-management. The meta-analysis revealed that mHealth supported interventions resulted in a significant reduction in pain (Hedge’s g -1.09, 95%CI -1.68 to -0.45) and disability (Hedge’s g -0.77, 95%CI -1.59 to 0.05). The post-treatment effect of the digital intervention was significant for physical function (Hedge’s g 2.54, 95%CI -4.08 to 4.08); yet nonsignificant for wellbeing (Hedge’s g 0.17, 95% CI -1.84 to 2.17), physical activity (Hedges’ g 0.09, 95%CI -0.59 to 0.50), anxiety (Hedge’s g -0.29, 95%CI -6.11 to 5.53), fatigue (Hedge’s g -0.34, 95%CI -5.84 to 5.16), calcium (Hedge’s g -0.05, 95%CI -0.59 to 0.50) and vitamin D (Hedge’s g 0.10, 95% CI -4.05 to 4.26) intake, and trabecular score (Hedge’s g 0.06, 95%CI -1.00 to 1.12). CONCLUSIONS Osteoporosis apps have the potential to support and improve the management of the disease and its symptoms; they also appear to be a valuable tool for patients and health professionals. However, the majority of the apps that are currently available lack clinically validated evidence of their efficacy and they most focus on a limited number of symptoms. A more holistic and personalized approach, within a co-creation design ecosystem, is needed.

PP215 An Evaluation Of The Scottish Medicine Consortium Detailed Advice Document

2021 ◽  
Vol 37 (S1) ◽  
pp. 27-27
Author(s):  
Solveiga Zibaite ◽  
Pamela Andrews ◽  
Fiona McTaggart ◽  
Pauline McGuire ◽  
Scott Hill
Keyword(s):  
Action Plan ◽  
Local Level ◽  
Health Technology ◽  
Health Board ◽  
Structured Interviews ◽  
Early Health Technology Assessment ◽  
Early Health ◽  
Primary Output ◽  
Initial Interviews ◽  
Purposive Sample

IntroductionThe Scottish Medicines Consortium (SMC) conducts early health technology assessment (HTA) of new medicines. The advice is implemented at the local level by 14 Health Board Area Drug and Therapeutics Committees (ADTCs). The primary output is a published document, the Detailed Advice Document (DAD), which aims to describe the strengths and weaknesses of the evidence considered and the rationale for the decision. We examined how the DAD is being used to determine areas for improvement.MethodsWe conducted semi-structured interviews with a purposive sample of SMC and ADTC members and formulary pharmacists, who are one of the key audiences. Interviews were recorded and transcribed using Microsoft Teams and coded in NVivo. The results were assessed via thematic analysis, which included major themes such as the structure and content of the DAD and its usefulness in supporting implementation of the advice from an ADTC perspective.ResultsFollowing initial interviews (n = 7), some early themes have emerged. The DAD is a valued tool describing the assessment of a medicine's clinical and cost effectiveness. The current length of the DADs and the technical language used can limit the accessibility of information, and there have been suggestions on how to improve the structure and content. Additional interviews are still being completed and full interview results (available early 2021) will be analyzed to identify key themes.ConclusionsThe DAD is the primary output of SMC's HTA process, which includes decisions on whether a medicine can be routinely prescribed in the National Health Service Scotland. DADs have increased in length over the years, reflecting the increasing complexity of new medicines and a corresponding increase in the size of pharmaceutical company submissions. The interviews conducted to date suggest that the DADs are highly regarded and support implementation of new medicines advice by the ADTC. The findings of this evaluation will lead to an action plan for improvement.

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