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Delivering Diabetes Education through Nurse-Led Telecoaching. Cost-Effectiveness Analysis

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  • Irina Odnoletkova
  • Dirk Ramaekers
  • Frank Nobels
  • Geert Goderis
  • Bert Aertgeerts
  • Lieven Annemans

Abstract

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

Suggested Citation

  • Irina Odnoletkova & Dirk Ramaekers & Frank Nobels & Geert Goderis & Bert Aertgeerts & Lieven Annemans, 2016. "Delivering Diabetes Education through Nurse-Led Telecoaching. Cost-Effectiveness Analysis," PLOS ONE, Public Library of Science, vol. 11(10), pages 1-18, October.
    • Handle: RePEc:plo:pone00:0163997
    DOI: 10.1371/journal.pone.0163997
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    1. Xin‐Jun Jiang & Hua Jiang & Yan‐Hui Lu & Shu‐Ling Liu & Jing‐Pin Wang & Rong‐Song Tang & Ming‐Zi Li, 2019. "The effectiveness of a self‐efficacy‐focused structured education programme on adults with type 2 diabetes: A multicentre randomised controlled trial," Journal of Clinical Nursing, John Wiley & Sons, vol. 28(17-18), pages 3299-3309, September.
    2. Hesti Platini & Artanti Lathifah & Sidik Maulana & Faizal Musthofa & Shakira Amirah & Muhammad Fahd Abdurrahman & Maria Komariah & Tuti Pahria & Kusman Ibrahim & Juan Alessandro Jeremis Maruli Nura Le, 2022. "Systematic Review and Meta-Analysis of Telecoaching for Self-Care Management among Persons with Type 2 Diabetes Mellitus," IJERPH, MDPI, vol. 20(1), pages 1-17, December.

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