Cost-effectiveness of a self-management and comprehensive training intervention in patients with type 2 diabetes up to 5 years of diagnosis in a specialized hospital in Mexico City

Hernández-Jiménez, Sergio; García-Ulloa, Ana Cristina; Anaya, P; Gasca-Pineda, Ricardo; Sánchez-Trujillo, Luis Arturo; Baca, Héctor Peña; González-Pier, Eduardo; Graue-Hernández, Enrique O; Aguilar-Salinas, Carlos A.; Gómez-Pérez, Franciso Javier; Kershenobich-Stalnikowitz, David

doi:10.1136/bmjdrc-2020-002097

Cited by 7 publications

(5 citation statements)

References 17 publications

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“… 28 Concurrently, novel interventions have been introduced and evaluated in Mexico to attain metabolic objectives, resulting in preservation of treatment goals. 29 , 30 …”

Section: Discussionmentioning

confidence: 99%

Health and Productivity Benefits with Early Intensified Treatment in Patients with Type 2 Diabetes: Results from Korea

Tsotra,

Malhotra,

Peristeris

et al. 2024

INQUIRY

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The available evidence suggests positive health outcomes associated with early treatment intensification in Type 2 diabetes mellitus (T2DM). Our study estimated the productivity effects arising from improved health correlated with early intensified treatment in T2DM in Korea. Using a recently published methodology and model, we investigated the association between early intensified treatment and the probability of experiencing fewer diabetes-related complication events. Treatment strategies leading to better health outcomes are expected to be associated with social value through increased participation in paid and unpaid work activities. Therefore, we translated the lower incidence of complications into monetary terms related to productivity for the Korean population. We quantified productivity by considering (a) absenteeism, (b) presenteeism, (c) permanent loss of labor force, and (d) activity restriction. Deterministic and probabilistic sensitivity analyses in the base case parameter were performed. Approximately, 1.7 thousand (standard deviation [SD] ±580 events) micro- and macrovascular complication events could potentially be avoided by early treatment intensification. This led to a societal gain attributed to increased productivity of 23 million USD (SD ± $8.2 million). This article demonstrates the likelihood of achieving better health and productivity through early intensified treatment in diabetes.

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“… 28 Concurrently, novel interventions have been introduced and evaluated in Mexico to attain metabolic objectives, resulting in preservation of treatment goals. 29 , 30 …”

Section: Discussionmentioning

confidence: 99%

Health and Productivity Benefits with Early Intensified Treatment in Patients with Type 2 Diabetes: Results from Korea

Tsotra,

Malhotra,

Peristeris

et al. 2024

INQUIRY

View full text Add to dashboard Cite

show abstract

“…The progression of relevant physiological parameters (eg, HbA 1c , systolic blood pressure, lipids, and BMI) is simulated based on long-term epidemiological data, and event risk is constantly updated on the basis of these risk factors. The model facilitates interconnectivity and interaction between the modeled complications, representing the complex and varied sequelae of diabetes [19].…”

Section: Discussionmentioning

confidence: 99%

“…A minimum approach is applied to the estimation of utilities-in the case of multiple events, the lower utility is applied for that period. This is a simple and well-established approach to the application of utilities in the case of multiple interdependent health states [17,19].…”

Section: Discussionmentioning

confidence: 99%

Health Care Resource Utilization in Adults Living With Type 1 Diabetes Mellitus in the South African Public Health Sector: Protocol for a 1-Year Retrospective Analysis With a 5-, 10-, and 25-Year Projection

Bhana¹,

Naidoo²,

Pillay³

et al. 2023

JMIR Res Protoc

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Background Type 1 diabetes mellitus (T1DM) is less common than type 2 diabetes mellitus but is increasing in frequency in South Africa. It tends to affect younger individuals, and upon diagnosis, exogenous insulin is essential for survival. In South Africa, the health care system is divided into private and public health care systems. The private system is well resourced, whereas the public sector, which treats more than 80% of the population, has minimal resources. There are currently no studies in South Africa, and Africa at large, that have evaluated the immediate and long-term costs of managing people living with T1DM in the public sector. Objective The primary objective was to quantify the cost of health care resource utilization over a 12-month period in patients with controlled and uncontrolled T1DM in the public health care sector. In addition, we will project costs for 5, 10, and 25 years and determine if there are cost differences in managing subsets of patients who achieve glycemic control (hemoglobin A1c [HbA1c] <7%) and those who do not. Methods The study was performed in accordance with Good Epidemiological Practice. Ethical clearance and institutional permissions were acquired. Clinical data were collected from 2 tertiary hospitals in South Africa. Patients with T1DM, who provided written informed consent, and who satisfied the inclusion criteria were enrolled in the study. Data collection included demographic and clinical characteristics, acute and chronic complications, hospital admissions, and so on. We plan to perform a cost-effectiveness analysis to quantify the costs of health care utilization in the preceding 12 months. In addition, we will estimate projected costs over the next 10 years, assuming that study participants maintain their current HbA1c level. The cost-effectiveness analysis will be modeled using the IQVIA CORE Diabetes Model. The primary outcome measures are incremental quality-adjusted life years, incremental costs, incremental cost-effectiveness ratios, and incremental life years. Results Ethical clearance and institutional approval were obtained (reference number 200407). Enrollment began on February 9, 2021, and was completed on August 24, 2021, with 224 participants. A database lock was performed on October 29, 2021. The statistical analysis and clinical study report were completed in January 2022. Conclusions At present, there are no data assessing the short- and long-term costs of managing patients with T1DM in the South African public sector. It is hoped that the findings of this study will help policy makers optimally use limited resources to reduce morbidity and mortality in people living with T1DM. International Registered Report Identifier (IRRID) RR1-10.2196/44308

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“…This study provides supporting evidence that an integrated diabetes care model is beneficial for increasing the skills and confidence of GPs in delivering best practice and evidence-based care for diabetes management. Evidence from studies conducted in Australia [30,31] and internationally [32,33] have shown that integrated healthcare delivery in primary care is cost-effective compared to usual models of care. Some GPs reported that the additional time taken for the preparation of case-conferences can be burdensome; however, it seemed that much of that time was needed for updating pathology, eye, and podiatry reviews which is a routine part of diabetes care.…”

Section: Discussionmentioning

confidence: 99%

Australian general practitioners’ perspectives on integrating specialist diabetes care with primary care: qualitative study

Taylor,

Acharya,

Parsons

et al. 2023

BMC Health Serv Res

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Background Improving the coordination and integration of health services is recognised nationally and internationally as a key strategy for improving the quality of diabetes care. The Australian Diabetes Alliance Program (DAP) is an integrated care model implemented in the Hunter New England Local Health District (HNELHD), New South Wales (NSW), in which endocrinologists and diabetes educators collaborate with primary care teams via case-conferencing, practice performance review, and education sessions. The objective of this study was to report on general practitioners’ (GPs) perspectives on DAP and whether the program impacts on their skills, knowledge, and approach in delivering care to adult patients with type 2 diabetes. Methods Four primary care practices with high rates of monitoring haemoglobin A1c (HbA1c) levels (> 90% of patients annually) and five practices with low rates of monitoring HbA1c levels (< 80% of patients annually) from HNELHD, NSW provided the sampling frame. A total of nine GPs were interviewed. The transcripts from the interviews were reviewed and analysed to identify emergent patterns and themes. Results Overall, GPs were supportive of DAP. They considered that DAP resulted in significant changes in their knowledge, skills, and approach and improved the quality of diabetes care. Taking a more holistic approach to care, including assessing patients with diabetes for co-morbidities and risk factors that may impact on their future health was also noted. DAP was noted to increase the confidence levels of GPs, which enabled active involvement in the provision of diabetes care rather than referring patients for tertiary specialist care. However, some indicated the program could be time consuming and greater flexibility was needed. Conclusions GPs reported DAP to benefit their knowledge, skills and approach for managing diabetes. Future research will need to investigate how to improve the intensity and flexibility of the program based on the workload of GPs to ensure long-term acceptability of the program.

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Cost-effectiveness of a self-management and comprehensive training intervention in patients with type 2 diabetes up to 5 years of diagnosis in a specialized hospital in Mexico City

Cited by 7 publications

References 17 publications

Health and Productivity Benefits with Early Intensified Treatment in Patients with Type 2 Diabetes: Results from Korea

Health and Productivity Benefits with Early Intensified Treatment in Patients with Type 2 Diabetes: Results from Korea

Health Care Resource Utilization in Adults Living With Type 1 Diabetes Mellitus in the South African Public Health Sector: Protocol for a 1-Year Retrospective Analysis With a 5-, 10-, and 25-Year Projection

Australian general practitioners’ perspectives on integrating specialist diabetes care with primary care: qualitative study

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