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- Title
Effects of telemonitoring on glycaemic control and healthcare costs in type 2 diabetes: A randomised controlled trial.
- Authors
Warren, Robin; Carlisle, Karen; Mihala, Gabor; Scuffham, Paul A.
- Abstract
Introduction This study examined the effect of a telehealth intervention on the control of type 2 diabetes and subsequent potential cost-savings to the health system. Methods This prospective randomised controlled trial randomised adults with type 2 diabetes to the intervention (diabetes program) or control (usual care) arm. Key eligibility criteria included an HbA1c level of at least 58 mmol/mol (7.5%) without severe or unstable comorbidities. All participants continued their usual healthcare, but participants in the intervention arm received additional diabetes care from a diabetes care coordinator via a home monitor that captured clinical measures. Data collected included biomedical, quality of life measures and healthcare (GP, outpatient and inpatient) costs. The primary outcome was HbA1c collected at baseline and 6 months. Analysis was conducted on a complete case intention-to-treat basis. The healthcare system perspective was taken to calculate the incremental cost per percentage-point reduction in HbA1c. Results Results from 63 participants from each study arm were analysed. HbA1c in the intervention group decreased from a median 68 mmol/mol (8.4%) to 58 mmol/mol (7.5%), and remained unchanged in the control group at median 65 mmol/mol (8.1%) at the 6-month endpoint. The intervention effect on HbA1c change was statistically significant ( p = .004). Total healthcare costs in the intervention group, including the intervention costs, were lower (mean $3781 vs. $4662; p < .001) compared with usual care. Discussion There was a clinically meaningful and statistically significant benefit from the telehealth intervention at a lower cost; thus, telehealth was cost-saving and produced greater health benefits compared with usual care.
- Subjects
QUEENSLAND; TELEMEDICINE; TYPE 2 diabetes; HEALTH care reform; MEDICAL care costs; GLYCOSYLATED hemoglobin; TYPE 2 diabetes treatment; MEDICAL care cost statistics; COMPARATIVE studies; COST effectiveness; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; QUALITY of life; RESEARCH; EVALUATION research; RANDOMIZED controlled trials; ECONOMICS
- Publication
Journal of Telemedicine & Telecare, 2018, Vol 24, Issue 9, p586
- ISSN
1357-633X
- Publication type
journal article
- DOI
10.1177/1357633X17723943