Cost effectiveness of group follow-up after structured education for type 1 diabetes: a cluster randomised controlled trial

Hdl Handle:
http://hdl.handle.net/10147/322929
Title:
Cost effectiveness of group follow-up after structured education for type 1 diabetes: a cluster randomised controlled trial
Authors:
Gillespie, Paddy; O'Shea, Eamon; O’Hara, Mary C; Dinneen, Sean F; for the Irish DAFNE Study Group
Citation:
Gillespie P et al. Cost effectiveness of group follow-up after structured education for type 1 diabetes: a cluster randomised controlled trial. Trials. 2014 Jun 14;15(1):227
Issue Date:
14-Jun-2014
URI:
http://dx.doi.org/10.1186/1745-6215-15-227; http://hdl.handle.net/10147/322929
Abstract:
Abstract Background This study examines the cost effectiveness of group follow-up after participation in the Dose Adjustment for Normal Eating (DAFNE) structured education programme for type 1 diabetes. Methods Economic evaluation conducted alongside a cluster randomised controlled trial involving 437 adults with type 1 diabetes in Ireland. Group follow-up involved two group education ‘booster’ sessions post-DAFNE. Individual follow-up involved two standard one-to-one hospital clinic visits. Incremental costs, quality-adjusted life years (QALYs) gained and cost effectiveness were estimated at 18 months. Uncertainty was explored using sensitivity analysis and by estimating cost effectiveness acceptability curves. Results Group follow-up was associated with a mean reduction in QALYs gained of 0.04 per patient (P value, 0.052; 95% CI, −0.08 to 0.01, intra-class correlation (ICC), 0.033) and a mean reduction in total healthcare costs of €772 (P value, 0.020; 95% CI, −1,415 to −128: ICC, 0.016) per patient. At alternative threshold values of €5,000, €15,000, €25,000, €35,000, and €45,000, the probability of group follow-up being cost effective was estimated to be 1.000, 0.762, 0.204, 0.078, and 0.033 respectively. Conclusions The results do not support implementation of group follow-up as the sole means of follow-up post-DAFNE. Given the reported cost savings, future studies should explore the cost effectiveness of alternative models of group care for diabetes. Trial registration Current Controlled Trials ISRCTN79759174 (assigned: 9 February 2007).
Item Type:
Article
Language:
en
Keywords:
DIABETES MELLITUS

Full metadata record

DC FieldValue Language
dc.contributor.authorGillespie, Paddyen_GB
dc.contributor.authorO'Shea, Eamonen_GB
dc.contributor.authorO’Hara, Mary Cen_GB
dc.contributor.authorDinneen, Sean Fen_GB
dc.contributor.authorfor the Irish DAFNE Study Groupen_GB
dc.date.accessioned2014-07-15T12:06:19Z-
dc.date.available2014-07-15T12:06:19Z-
dc.date.issued2014-06-14-
dc.identifier.citationGillespie P et al. Cost effectiveness of group follow-up after structured education for type 1 diabetes: a cluster randomised controlled trial. Trials. 2014 Jun 14;15(1):227en_GB
dc.identifier.urihttp://dx.doi.org/10.1186/1745-6215-15-227-
dc.identifier.urihttp://hdl.handle.net/10147/322929-
dc.description.abstractAbstract Background This study examines the cost effectiveness of group follow-up after participation in the Dose Adjustment for Normal Eating (DAFNE) structured education programme for type 1 diabetes. Methods Economic evaluation conducted alongside a cluster randomised controlled trial involving 437 adults with type 1 diabetes in Ireland. Group follow-up involved two group education ‘booster’ sessions post-DAFNE. Individual follow-up involved two standard one-to-one hospital clinic visits. Incremental costs, quality-adjusted life years (QALYs) gained and cost effectiveness were estimated at 18 months. Uncertainty was explored using sensitivity analysis and by estimating cost effectiveness acceptability curves. Results Group follow-up was associated with a mean reduction in QALYs gained of 0.04 per patient (P value, 0.052; 95% CI, −0.08 to 0.01, intra-class correlation (ICC), 0.033) and a mean reduction in total healthcare costs of €772 (P value, 0.020; 95% CI, −1,415 to −128: ICC, 0.016) per patient. At alternative threshold values of €5,000, €15,000, €25,000, €35,000, and €45,000, the probability of group follow-up being cost effective was estimated to be 1.000, 0.762, 0.204, 0.078, and 0.033 respectively. Conclusions The results do not support implementation of group follow-up as the sole means of follow-up post-DAFNE. Given the reported cost savings, future studies should explore the cost effectiveness of alternative models of group care for diabetes. Trial registration Current Controlled Trials ISRCTN79759174 (assigned: 9 February 2007).-
dc.language.isoenen
dc.subjectDIABETES MELLITUSen_GB
dc.titleCost effectiveness of group follow-up after structured education for type 1 diabetes: a cluster randomised controlled trialen_GB
dc.typeArticleen
dc.language.rfc3066en-
dc.rights.holderPaddy Gillespie et al.; licensee BioMed Central Ltd.-
dc.description.statusPeer Reviewed-
dc.date.updated2014-06-25T11:34:27Z-
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