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:


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 consulta-tion
(Web conferenc-ing software)

Home monitoring equipment
– Insulin pump
– Blood glucose monitor
– Continuous glucose monitor


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:


Costs and organization:


Home monitoring equipment

– Blood glucose monitor

– Continuous glucose monitor

– Web conferencing software



Staff resources

– Online individual and group sessions




Health care utilization:

– Health related utility ↓

– Cost, direct →

– Cost indirect →

– hospitalizations →

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“↑”: Statistically significant increase

“↓”: Statistically significant decrease

“→”: Statistically insignificant (no difference)