scholarly journals Cost-Utility of an Online Education Platform and Diabetes Personal Health Record: Analysis Over Ten Years

2022 ◽  
pp. 193229682110691
Author(s):  
Scott G. Cunningham ◽  
Andrew Stoddart ◽  
Sarah H. Wild ◽  
Nicholas J. Conway ◽  
Alastair M. Gray ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Online Education ◽  
Diabetes Education ◽  
Personal Health Record ◽  
Cost Utility ◽  
Mobile App ◽  
Personal Health ◽  
Life Years ◽  
Matching Criteria

Background and Aims: My Diabetes My Way (MDMW) is Scotland’s interactive website and mobile app for people with diabetes and their caregivers. It contains multimedia resources for diabetes education and offers access to electronic personal health records. This study aims to assess the cost-utility of MDMW compared with routine diabetes care in people with type 2 diabetes who do not use insulin. Materials and Methods: Analysis used the United Kingdom Prospective Diabetes Study (UKPDS) Outcomes Model 2. Clinical parameters of MDMW users (n = 2576) were compared with a matched cohort of individuals receiving routine care alone (n = 11 628). Matching criteria: age, diabetes duration, sex, and socioeconomic status. Impact on life expectancy, quality-adjusted life years (QALYs), and costs of treatment and complications were simulated over ten years, including a 10% sensitivity analysis. Results: MDMW cohort: 1670 (64.8%) men; average age 64.3 years; duration of diabetes 5.5 years. 906 (35.2%) women: average age 61.6 years; duration 4.7 years. The cumulative mean QALY (95% CI) gain: 0.054 (0.044-0.062) years. Mean difference in cost: –£118.72 (–£150.16 to –£54.16) over ten years. Increasing MDMW costs (10%): –£50.49 (–£82.24-£14.14). Decreasing MDMW costs (10%): –£186.95 (–£218.53 to –£122.51). Conclusions: MDMW is “dominant” over usual care (cost-saving and life improving) in supporting self-management in people with type 2 diabetes not treated with insulin. Wider use may result in significant cost savings through delay or reduction of long-term complications and improved QALYs in Scotland and other countries. MDMW may be among the most cost-effective interventions currently available to support diabetes.

scholarly journals A systematic review of economic evaluations in non-insulin antidiabetic treatments for patients with type 2 diabetes mellitus

2019 ◽  
Vol 2019 ◽  
pp. 228424031987657 ◽  
Author(s):  
Néboa Zozaya ◽  
Margarita Capel ◽  
Susana Simón ◽  
Alfonso Soto-González
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Management Strategies ◽  
Cost Effective ◽  
Cost Utility ◽  
Economic Evaluations ◽  
Life Years ◽  
Comparative Results

The approval of new non-insulin treatments has broadened the therapeutic arsenal, but it has also increased the complexity of choice for the treatment of type 2 diabetes mellitus (DM2). The objective of this study was to systematically review the literature on economic evaluations associated with non-insulin antidiabetic drugs (NIADs) for DM2. We searched in Medline, IBECS, Doyma and SciELO databases for full economic evaluations of NIADs in adults with DM2 applied after the failure of the first line of pharmacological treatment, published between 2010 and 2017, focusing on studies that incorporated quality-adjusted life years (QALYs). The review included a total of 57 studies, in which 134 comparisons were made between NIADs. Under an acceptability threshold of 25,000 euros per QALY gained, iSLGT-2 were preferable to iDPP-4 and sulfonylureas in terms of incremental cost-utility. By contrast, there were no conclusive comparative results for the other two new NIAD groups (GLP-1 and iDPP-4). The heterogeneity of the studies’ methodologies and results hindered our ability to determine under what specific clinical assumptions some NIADs would be more cost-effective than others. Economic evaluations of healthcare should be used as part of the decision-making process, so multifactorial therapeutic management strategies should be established based on the patients’ clinical characteristics and preferences as principal criteria.

A Diabetes Mobile App With In-App Coaching From a Certified Diabetes Educator Reduces A1C for Individuals With Type 2 Diabetes

2018 ◽  
Vol 44 (3) ◽  
pp. 226-236 ◽  
Author(s):  
Shefali Kumar ◽  
Heidi Moseson ◽  
Jaspreet Uppal ◽  
Jessie L. Juusola
Keyword(s):  
Type 2 Diabetes ◽  
Repeated Measures ◽  
Diabetes Education ◽  
Study Data ◽  
Mobile App ◽  
Diabetes Educator ◽  
N 93 ◽  
Intent To Treat ◽  
The Impact

Purpose There are currently many diabetes apps available, but there is limited evidence demonstrating clinical impact. The purpose of this study is to evaluate the impact of a diabetes mobile app with in-app coaching by a certified diabetes educator on glycemic control for individuals with type 2 diabetes. Methods A 12 week-long single-arm intent-to-treat trial evaluated the impact of a diabetes mobile app and coaching program (One Drop | Mobile With One Drop | Experts), which facilitated tracking of self-care and included an in-app diabetes education program, on A1C for individuals with type 2 diabetes and an A1C ≥7.5% (58 mmol/mol). An online study platform (Achievement Studies, Evidation Health Inc, San Mateo, CA) was used to screen, consent, and enroll participants; collect study data; and track participants’ progress throughout the study. Baseline and study end A1C measurements as well as questionnaire data from participants were collected. Results Participants (n = 146) were 52 ± 9 years old, 71% female, 25% black or Hispanic, diagnosed with diabetes for 11 ± 7 years, and with a mean baseline A1C of 9.87% ± 2.0 (84 mmol/mol). In adjusted repeated measures models, mean A1C improved by −0.86% among study completers (n = 127), −0.96% among active users of the app and coaching program (n = 93), and −1.32% among active users with a baseline A1C ≥9.0% (75 mmol/mol) (n = 53). Conclusions This program was associated with a clinically meaningful and significant reduction in A1C and can potentially increase access to effective diabetes self-management education and support for individuals with diabetes.

scholarly journals Uptake and Effects of the e-Vita Personal Health Record with Self-Management Support and Coaching, for Type 2 Diabetes Patients Treated in Primary Care

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
M. van Vugt ◽  
M. de Wit ◽  
F. Sieverink ◽  
Y. Roelofsen ◽  
S. H. Hendriks ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Personal Health Record ◽  
Self Management ◽  
Personal Health ◽  
Health Record ◽  
Management Support ◽  
Emotional Wellbeing ◽  
Diabetes Patients

We studied the use, uptake, and effects of e-Vita, a personal health record, with self-management support and personalized asynchronized coaching, for type 2 diabetes patients treated in primary care. Patients were invited by their practice nurse to join the study aimed at testing use and effects of a personal health record. Patients were followed up for 6 months. Uptake and usage were monitored using log data. Outcomes were self-reported diabetes self-care, diabetes-related distress, and emotional wellbeing. Patients’ health status was collected from their medical chart. 132 patients agreed to participate in the study of which less than half (46.1%) did not return to the personal health record after 1st login. Only 5 patients used the self-management support program within the personal health record, 3 of whom asked a coach for feedback. Low use of the personal health record was registered. No statistical significant differences on any of the outcome measures were found between baseline and 6 month follow-up. This study showed minimal impact of implementing a personal health record including self-management support in primary diabetes care. Successful adoption of web-based platforms, as ongoing patient centered care, is hard to achieve without additional strategies aimed at enhancing patient motivation and engaging professionals.

scholarly journals Smartphone-Based mHealth and Internet of Things for Diabetes Control and Self-Management

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Abolfazl Mehbodniya ◽  
A. Suresh Kumar ◽  
Kantilal Pitambar Rane ◽  
Komal Kumar Bhatia ◽  
Bhupesh Kumar Singh
Keyword(s):  
Type 2 Diabetes ◽  
Mobile Phone ◽  
Self Care ◽  
Mobile App ◽  
Self Management ◽  
The Internet ◽  
Diabetic Patients ◽  
Life Years ◽  
Diabetes Patients

In patients with chronic diseases condition, mobile health monitoring facility proves to play a significant role in providing significant assistance toward personal management. This research examined the use of smartphones by diabetes patients and their intentions to apply them for self-care and monitoring as well as management. This cross-sectional survey-based study was conducted in Jul-Aug 2021 with 200 diabetic patients (especially type 2) who were visiting specialized clinics and hospitals of Gujrat state, India. A validated questionnaire survey was designed to collect data, which included questions about demographics, information pertaining to other, use of cellphones, the Internet, and the intention to implement smartphones for diabetes monitoring, self-care, and self-management. A highest number of studied participants have mobile phone (97.5%) and smartphones (87%) and access the Internet on daily basis (83.5%). Younger participants were more inclined to use smartphone apps and have also shown more interest for continuous use in the future ( p < 0.01 ). The majority of participants used apps for nutritional planning (85.5%), to monitor glucose control (76.5%), and for scheduling of diabetes appointments on the calendar (90.5%). Recommendations to use mobile app by doctors or healthcare profession were reported by 20.5% of the participants and attitude and future intention to use mobile apps were reported by the majority of participants. The majority of type 2 diabetes patients choose to use their cellphones and the internet or mobile phone reminder system for medication as well as to plan their diets, monitor their blood sugar levels, and communicate with their doctors. The findings of this research can be used to develop strategies and implement mHealth-based therapies to assist patients with type 2 diabetes to efficiently manage their health and might contribute to reducing patients’ out-of-pocket expenditure as well as reducing disability-adjusted life years (DAILY) attributed by DM.

scholarly journals Cost–utility analysis of lifestyle interventions to prevent type 2 diabetes in women with prior gestational diabetes

2019 ◽  
Vol 30 (3) ◽  
pp. 396-401
Author(s):  
Amber Werbrouck ◽  
Masja Schmidt ◽  
Koen Putman ◽  
Lieven Annemans ◽  
Katrien Benhalima ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Gestational Diabetes ◽  
Cost Effective ◽  
Cost Utility ◽  
Sensitivity Analyses ◽  
Lifestyle Interventions ◽  
Reminder System ◽  
Scenario Analyses ◽  
Life Years

Abstract Background To compare estimated costs and health outcomes of lifestyle interventions for the prevention of type 2 diabetes mellitus in women who had gestational diabetes. Methods An age-specific Markov model was applied comparing costs and quality-adjusted life years (QALYs) of three alternatives: ‘doing nothing’; an annual reminder system (ARS) with an awareness campaign (‘ARS-awareness’); and an ARS with an intensive lifestyle intervention (‘ARS-ILS’). A healthcare payer perspective was adopted, the time horizon was 30 years and the setting was Flanders (Belgium). Sensitivity analyses were performed. Results ‘ARS-awareness’ was extendedly dominated. Per 10 000 participants, ‘ARS-ILS’ cost €13 210 256 more and gained 496 QALYs compared with ‘doing nothing’ (26 632 €/QALY), with a 63% probability of being cost effective, given a cost effectiveness threshold of 35 000 €/QALY. A scenario analysis showed that ‘ARS-ILS’ for 15 years only offered to women with prediabetes (compared with ‘doing nothing’) has an 89.5% likelihood of being dominant. Conclusions ‘ARS-ILS’ may be the preferred intervention. However, the probability of being cost effective was low. Based on further scenario analyses, we recommend healthcare decision makers to consider the application of a more intensive alternative, focused on the highest risk profiles and with a shorter intervention duration.

scholarly journals The Added Value of Log File Analyses of the Use of a Personal Health Record for Patients With Type 2 Diabetes Mellitus

2014 ◽  
Vol 8 (2) ◽  
pp. 247-255 ◽  
Author(s):  
Floor Sieverink ◽  
Saskia M. Kelders ◽  
Louise M. A. Braakman-Jansen ◽  
Julia E. W. C. van Gemert-Pijnen
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Personal Health Record ◽  
Added Value ◽  
Personal Health ◽  
Health Record ◽  
Log File

621-P: Digital Diabetes Education Program Improves Knowledge, Self-Efficacy, and Health Behaviors among People with Type 2 Diabetes

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 621-P
Author(s):  
ZACHARY WHITE ◽  
RYAN WOOLLEY ◽  
SHEILA AMANAT ◽  
KELLY MUELLER
Keyword(s):  
Type 2 Diabetes ◽  
Health Behaviors ◽  
Education Program ◽  
Self Efficacy ◽  
Diabetes Education
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