Cost effectiveness review of text messaging, smartphone application, and website interventions targeting T2DM or hypertension

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cris.lastimport.scopus2025-04-04T03:13:34Z
dc.abstract.enDigital health interventions have been shown to be clinically-effective for type 2 diabetes mellitus (T2DM) and hypertension prevention and treatment. This study synthesizes and compares the cost-effectiveness of text-messaging, smartphone application, and websites by searching CINAHL, Cochrane Central, Embase, Medline and PsycInfo for full economic or cost-minimisation studies of digital health interventions in adults with or at risk of T2DM and/or hypertension. Costs and health effects are synthesised narratively. Study quality appraisal using the Consensus on Health Economic Criteria (CHEC) list results in recommendations for future health economic evaluations of digital health interventions. Of 3056 records identified, 14 studies are included (7 studies applied text-messaging, 4 employed smartphone applications, and 5 used websites). Ten studies are cost-utility analyses: incremental cost-utility ratios (ICUR) vary from dominant to €75,233/quality-adjusted life year (QALY), with a median of €3840/QALY (interquartile range €16,179). One study finds no QALY difference. None of the three digital health intervention modes is associated with substantially better cost-effectiveness. Interventions are consistently cost-effective in populations with (pre)T2DM but not in populations with hypertension. Mean quality score is 63.0% (standard deviation 13.7%). Substandard application of time horizon, sensitivity analysis, and subgroup analysis next to transparency concerns (regarding competing alternatives, perspective, and costing) downgrades quality of evidence. In conclusion, smartphone application, text-messaging, and website-based interventions are cost-effective without substantial differences between the different delivery modes. Future health economic studies should increase transparency, conduct sufficient sensitivity analyses, and appraise the ICUR more critically in light of a reasoned willingness-to-pay threshold.
dc.affiliationInstytut Psychologii
dc.contributor.authorWillems, Ruben
dc.contributor.authorAnnemans, Lieven
dc.contributor.authorSiopis, George
dc.contributor.authorMoschonis, George
dc.contributor.authorVedanthan, Rajesh
dc.contributor.authorJung, Jenny
dc.contributor.authorKwaśnicka, Dominika
dc.contributor.authorOldenburg, Brian
dc.contributor.authord’Antonio, Claudia
dc.contributor.authorGirolami, Sandro
dc.contributor.authorAgapidaki, Eirini
dc.contributor.authorManios, Yannis
dc.contributor.authorVerhaeghe, Nick
dc.contributor.authorUsheva, Natalya
dc.contributor.authorIotova, Violeta
dc.contributor.authorTriantafyllidis, Andreas
dc.contributor.authorVotis, Konstantinos
dc.contributor.authorToti, Florian
dc.contributor.authorMakrilakis, Konstantinos
dc.contributor.authorSeghieri, Chiara
dc.contributor.authorMoreno, Luis
dc.contributor.authorDupont, Sabine
dc.contributor.authorLewis, Leo
dc.contributor.authorDjokic, Djordje
dc.contributor.authorSkouteris, Helen
dc.date.access2023-08-18
dc.date.accessioned2023-10-19T09:00:22Z
dc.date.available2023-10-19T09:00:22Z
dc.date.created2023-07-07
dc.date.issued2023-08-18
dc.description.abstract<jats:title>Abstract</jats:title><jats:p>Digital health interventions have been shown to be clinically-effective for type 2 diabetes mellitus (T2DM) and hypertension prevention and treatment. This study synthesizes and compares the cost-effectiveness of text-messaging, smartphone application, and websites by searching CINAHL, Cochrane Central, Embase, Medline and PsycInfo for full economic or cost-minimisation studies of digital health interventions in adults with or at risk of T2DM and/or hypertension. Costs and health effects are synthesised narratively. Study quality appraisal using the Consensus on Health Economic Criteria (CHEC) list results in recommendations for future health economic evaluations of digital health interventions. Of 3056 records identified, 14 studies are included (7 studies applied text-messaging, 4 employed smartphone applications, and 5 used websites). Ten studies are cost-utility analyses: incremental cost-utility ratios (ICUR) vary from dominant to €75,233/quality-adjusted life year (QALY), with a median of €3840/QALY (interquartile range €16,179). One study finds no QALY difference. None of the three digital health intervention modes is associated with substantially better cost-effectiveness. Interventions are consistently cost-effective in populations with (pre)T2DM but not in populations with hypertension. Mean quality score is 63.0% (standard deviation 13.7%). Substandard application of time horizon, sensitivity analysis, and subgroup analysis next to transparency concerns (regarding competing alternatives, perspective, and costing) downgrades quality of evidence. In conclusion, smartphone application, text-messaging, and website-based interventions are cost-effective without substantial differences between the different delivery modes. Future health economic studies should increase transparency, conduct sufficient sensitivity analyses, and appraise the ICUR more critically in light of a reasoned willingness-to-pay threshold.</jats:p><jats:p><jats:bold>Registration:</jats:bold> PROSPERO (CRD42021247845).</jats:p>
dc.description.accesstimeat_publication
dc.description.physical1-13
dc.description.versionfinal_published
dc.description.volume6
dc.identifier.doi10.1038/s41746-023-00876-x
dc.identifier.issn2398-6352
dc.identifier.urihttps://share.swps.edu.pl/handle/swps/84
dc.identifier.weblinkhttps://www.nature.com/articles/s41746-023-00876-x
dc.languageen
dc.pbn.affiliationpsychologia
dc.rightsCC-BY
dc.rights.questionYes_rights
dc.share.articleOPEN_JOURNAL
dc.subject.enHealth care economics
dc.subject.enHypertension
dc.subject.enMetabolic disorders
dc.subject.enPre-diabetes
dc.subject.enType 2 diabetes
dc.swps.sciencecloudsend
dc.titleCost effectiveness review of text messaging, smartphone application, and website interventions targeting T2DM or hypertension
dc.title.journalnpj Digital Medicine
dc.typeJournalArticle
dspace.entity.typeArticle