The WISDOM self‐management intervention: A cost‐effectiveness analysis to support the transformation of type 2 diabetes care in England

Abstract

Objectives: To assess the cost-effectiveness of the WISDOM self-management intervention for type 2 diabetes compared with care as usual. Design:We performed a difference-in-differences analysis to estimate differences in risk factors for diabetes complications between people in the WISDOM group (n = 25, 276) and a control group (n = 15, 272) using GP records. A decision analytic model was then used to extrapolate differences in risk factors into costs and outcomes in the long term.Setting: Participating GP practices in West Hampshire and Southampton, UK.

Population health interventions for cardiometabolic diseases in primary care: a scoping review and RE-AIM evaluation of current practices

“…Among the 21 interventions reviewed, nine interventions (43%) focused on patients at risk of (progression of) cardiovascular diseases ( 20 , 23 , 26 , 27 , 34–37 , 44 ), six interventions (29%) on diabetes ( 18 , 19 , 22 , 24 , 28 , 33 ), and six interventions (29%) on CMD ( 25 , 30–33 , 38 ). Of the 12 interventions that evaluated diabetes outcome measurements, only one (5%) reported no statistically significant impact ( 28 ), while six reported significantly positive outcomes on diabetes control ( 18 , 19 , 25 , 30 , 31 , 38 ). Two interventions (10%) focused on feasibility and acceptability outcomes and found positive results in terms of better understanding and proficiency in managing individuals with complex diabetes in a primary care setting through PHM ( 24 , 33 ).…”

“…Two interventions (10%) focused on feasibility and acceptability outcomes and found positive results in terms of better understanding and proficiency in managing individuals with complex diabetes in a primary care setting through PHM ( 24 , 33 ). Only two interventions reported unintended consequences of the intervention ( 20 , 23 ), and only one measured quality of life ( 18 ). A minority of interventions (24%) addressed the cost of the intervention ( 18 , 23 , 26 , 29 , 33 ), of which one included a formal cost-effectiveness analysis ( 18 ).…”

“…Only two interventions reported unintended consequences of the intervention ( 20 , 23 ), and only one measured quality of life ( 18 ). A minority of interventions (24%) addressed the cost of the intervention ( 18 , 23 , 26 , 29 , 33 ), of which one included a formal cost-effectiveness analysis ( 18 ).…”

Fuelling inequality

“…It also includes a healthcare professionals' education programme. 4 Not only is the programmeclinicallyeffectiveforpeoplewithtype2diabetes,associatedwithreducedratesofatrialfibrillation, albuminuriaandhypertension,butitisalsocost-effective.…”

“…The WISDOM intervention is a collaboration between primary care clusters focussing on population health, integration of care, risk stratification using electronic health records and proactive treatment. It also includes a healthcare professionals' education programme 4 . Not only is the programme clinically effective for people with type 2 diabetes, associated with reduced rates of atrial fibrillation, albuminuria and hypertension, but it is also cost‐effective.…”