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Pediatric Weight Management Through mHealth Compared to Face-to-Face Care: Cost Analysis of a Randomized Control Trial.
Tully, Louise; Sorensen, Jan; O'Malley, Grace.
  • Tully L; Obesity Research and Care Group, Division of Population Health Sciences, School of Physiotherapy, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland.
  • Sorensen J; Healthcare Outcomes Research Centre, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland.
  • O'Malley G; Obesity Research and Care Group, Division of Population Health Sciences, School of Physiotherapy, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland.
JMIR Mhealth Uhealth ; 9(9): e31621, 2021 09 14.
Article in English | MEDLINE | ID: covidwho-1443996
ABSTRACT

BACKGROUND:

Mobile health (mHealth) may improve pediatric weight management capacity and the geographical reach of services, and overcome barriers to attending physical appointments using ubiquitous devices such as smartphones and tablets. This field remains an emerging research area with some evidence of its effectiveness; however, there is a scarcity of literature describing economic evaluations of mHealth interventions.

OBJECTIVE:

We aimed to assess the economic viability of using an mHealth approach as an alternative to standard multidisciplinary care by evaluating the direct costs incurred within treatment arms during a noninferiority randomized controlled trial (RCT).

METHODS:

A digitally delivered (via a smartphone app) maintenance phase of a pediatric weight management program was developed iteratively with patients and families using evidence-based approaches. We undertook a microcosting exercise and budget impact analysis to assess the costs of delivery from the perspective of the publicly funded health care system. Resource use was analyzed alongside the RCT, and we estimated the costs associated with the staff time and resources for service delivery per participant.

RESULTS:

In total, 109 adolescents participated in the trial, and 84 participants completed the trial (25 withdrew from the trial). We estimated the mean direct cost per adolescent attending usual care at €142 (SD 23.7), whereas the cost per adolescent in the mHealth group was €722 (SD 221.1), with variations depending on the number of weeks of treatment completion. The conversion rate for the reference year 2013 was $1=€0.7525. The costs incurred for those who withdrew from the study ranged from €35 to €681, depending on the point of dropout and study arm. The main driver of the costs in the mHealth arm was the need for health professional monitoring and support for patients on a weekly basis. The budget impact for offering the mHealth intervention to all newly referred patients in a 1-year period was estimated at €59,046 using the assessed approach.

CONCLUSIONS:

This mHealth approach was substantially more expensive than usual care, although modifications to the intervention may offer opportunities to reduce the mHealth costs. The need for monitoring and support from health care professionals (HCPs) was not eliminated using this delivery model. Further research is needed to explore the cost-effectiveness and economic impact on families and from a wider societal perspective. TRIAL REGISTRATION ClinicalTrials.gov NCT01804855; https//clinicaltrials.gov/ct2/show/NCT01804855.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Telemedicine / Nutrition Therapy Type of study: Experimental Studies / Prognostic study / Randomized controlled trials Limits: Adolescent / Child / Humans Language: English Journal: JMIR Mhealth Uhealth Year: 2021 Document Type: Article Affiliation country: 31621

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Telemedicine / Nutrition Therapy Type of study: Experimental Studies / Prognostic study / Randomized controlled trials Limits: Adolescent / Child / Humans Language: English Journal: JMIR Mhealth Uhealth Year: 2021 Document Type: Article Affiliation country: 31621