Cost-effectiveness of Shared Telemedicine Appointments in Young Adults With T1D: CoYoT1 Trial.

Source: Wan, W., et al. 2019 - Pubmed ID: 31189564

Setting: USA, Diabetes center

Study design:

CT-pro

 

Follow up: 9 months

Patient group:

Sample size:

Total: 81 (70)

IG: 42 (42)

CG: 39 (28)

 

Inclusion criteria:

  • Diabetes type 1
  • Age 18-25 years
Type of technology:

Video consultation (Web conferencing software)

 

Home monitoring

  • Insulin pump
  • Blood glucose monitor
  • Continuous glucose monitor
Intervention:

Intervention: Patients completed 3 telemedicine visits and one in-person appointment with care provider. Before appointment pt. upload data from diabetes management devices. During telehealth visit care provider reviewed clinical data and discussed barriers to individual diabetes management. As a part of teleconsultations online group sessions were held consisting of four patients.

 

Duration: 12 months one appointment every 3 months.
Add on:

 

Control group: Treatment as usual, in person individual appointment every 3months

Clinical effect/ Patient safety:

Clinical effect:

  • Health related utility ↓
  • QALY →
  • Diabetes related distress ↓
  • HbA1c →
  • BMI →

Patient safety: No difference in number of severe hyperglycemia (and hypoglycemia) events,

Patient experiences/ Staff experiences:

Patient experiences: IG had more study related visits but fewer non study office visits.

 

Staff experiences: NA

Costs and organization:

Investment:
Equipment/Materials

  • Blood glucose monitor
  • Continuous glucose monitor
  • Web conferencing software

Running:
Staff resources

  • Online individual and group sessions

 

Organization: NA

Health care utilization:

  • Health related utility ↓
  • Cost, direct →
  • Cost indirect →
  • Hospitalizations →
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Information

“↑”: Statistically significant increase

“↓”: Statistically significant decrease

“→”: Statistically insignificant (no difference)