A systematic review of economic evaluations of web‐based or telephone‐delivered interventions for preventing overweight and obesity and/or improving obesity‐related behaviors

Abstract

Summary Obesity prevention interventions with behavioral or lifestyle‐related components delivered via web‐based or telephone technologies have been reported as comparatively low cost as compared with other intervention delivery modes, yet to date, no synthesized evidence of cost‐effectiveness has been published. This study aimed to conduct a systematic review of economic evaluations of obesity prevention interventions with a telehealth or eHealth intervention component. A systematic search of six academic databases was conducted through October 2020. Studies were included if they reported full economic evaluations of interventions aimed at preventing overweight or obesity, or interventions aimed at improving obesity‐related behaviors, with at least one intervention component delivered by telephone (telehealth) or web‐based technology (eHealth). Findings were reported narratively, based on the Consolidated Health Economic Evaluation Reporting Standards. Twenty‐seven economic evaluations were included from 20 studies meeting the inclusion criteria. Sixteen of the included interventions had a telehealth component, whereas 11 had an eHealth component. Seventeen interventions were evaluated using cost‐utility analysis, five with cost‐effectiveness analysis, and five undertook both cost‐effectiveness and cost‐utility analyses. Only eight cost‐utility analyses reported that the intervention was cost‐effective. Comparison of results from cost‐effectiveness analyses was limited by heterogeneity in methods and outcome units reported. The evidence supporting the cost‐effectiveness of interventions with a telehealth or eHealth delivery component is currently inconclusive. Although obesity prevention telehealth and eHealth interventions are gaining popularity, more evidence is required on their effectiveness and cost‐effectiveness.

The Effectiveness of Web-Based Interventions to Promote Health Behaviour Change in Adolescents: A Systematic Review

“…Most previous systematic reviews about digital health interventions are limited to the self-management of clinical conditions or symptoms instead of focusing on health promotion [ 43 , 44 , 45 , 46 , 47 ] or try to understand only one major health outcome change such as nutrition-related behaviours [ 48 , 49 , 50 , 51 ], sedentary behaviours [ 52 ] and physical activity [ 53 ], depression and mental health [ 54 ], alcohol-related problems [ 55 ] and their target population is other than adolescents such as adults [ 56 ] and older adults [ 57 ].…”

Pediatric Weight Management Through mHealth Compared to Face-to-Face Care: Cost Analysis of a Randomized Control Trial

“…Previous studies have demonstrated that families who live further from clinics, or for whom travel to in-person appointments is more burdensome or complex, tend to view telemedicine more favorably [ 27 ]. Despite this, most published economic evaluations of telemedicine consider the perspectives of only the health care service/provider, as shown for cardiovascular disease management [ 28 ], obesity prevention [ 6 ], and eHealth more broadly [ 29 ]. It is important for researchers to assess delivery costs for future evaluations of digitally delivered pediatric weight management to build an evidence base for this population with unique care needs [ 30 ].…”

“…For excess adiposity in childhood, family-orientated multidisciplinary weight management, consisting of nutrition and physical activity support with integration of evidence-based behavior-change techniques, is recommended as the cornerstone of treatment [ 2 - 4 ]. There is evidence that telemedicine interventions can support self-management of nutrition and physical activity in children and adolescents [ 5 ]; however, there is a scarcity of studies focusing on the economic evaluations of such interventions, particularly for mHealth interventions developed to incorporate evidence-based approaches [ 1 , 5 , 6 ].…”

Digital intervention promoting physical activity among obese people (DIPPAO) randomised controlled trial: study protocol

“…Nevertheless, no rigorous trial has yet demonstrated the superiority of digital PA interventions over existing ones. Although e-health interventions are gaining popularity for the treatment of obesity, appearing advantageous compared with current programmes, no evidence of cost-effectiveness has been demonstrated 17. In addition, concerns remain regarding the adherence rate and engagement in the long term 18.…”

“…Although e-health interventions are gaining popularity for the treatment of obesity, appearing advantageous compared with current programmes, no evidence of cost-effectiveness has been demonstrated. 17 In addition, concerns remain regarding the adherence rate and engagement in the long term. 18 Therefore, the use of gamification appears as an interesting way to address these limits.…”