Cost-effectiveness analysis of a school- and community-based intervention to promote a healthy lifestyle and prevent type 2 diabetes in vulnerable families across Europe: the Feel4Diabetes-study

Willems, Ruben; Tsoutsoulopoulou, Konstantina; Brondeel, Ruben; Cardon, Greet; Makrilakis, Konstantinos; Liatis, Stavros; Lindström, Jaana; Kivelä, Jemina; González-Gil, Esther M.; Giménez-Legarre, Natalia; Usheva, Natalya; Iotova, Violeta; Tankova, Tsvetalina; Antal, Emese; Rurik, Imre; Timpel, Patrick; Schwarz, Peter E. H.; Μanios, Yannis; Annemans, Lieven

doi:10.1016/j.ypmed.2021.106722

Cited by 4 publications

(4 citation statements)

References 28 publications

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“…In our review, six of the studies assessed such programs and documented mixed results. Certain programs showed promising outcomes including Physical Activity 4 Everyone [ 23 ], Feel4Diabetes [ 27 ] and CHRIPY DRAGON [ 29 ]. One particular program, The West Midlands ActiVe lifestyle and healthy Eating in School children (WAVES), targeted both the school and family environment [ 28 , 29 ].…”

Section: Resultsmentioning

confidence: 99%

The cost-effectiveness of school-based interventions for chronic diseases: a systematic review

Lin,

Werner,

Alqunaiebet

et al. 2024

Cost Eff Resour Alloc

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Background Chronic diseases, or non-communicable diseases (NCD), are conditions of long duration and often influenced and contributed by complex interactions of several variables, including genetic, physiological, environmental, and behavioral factors. These conditions contribute to death, disability, and subsequent health care costs. Primary and secondary school settings provide an opportunity to deliver relatively low cost and effective interventions to improve public health outcomes. However, there lacks systematic evidence on the cost-effectiveness of these interventions. Methods We systematically searched four databases (PubMed/Medline, Cochrane, Embase, and Web of Science) for published studies on the cost-effectiveness of chronic-disease interventions in school settings. Studies were eligible for inclusion if they assessed interventions of any chronic or non-communicable disease, were conducted in a school setting, undertook a full cost-effectiveness analysis and were available in English, Spanish, or French. Results Our review identified 1029 articles during our initial search of the databases, and after screening, 33 studies were included in our final analysis. The most used effectiveness outcome measures were summary effectiveness units such as quality-adjusted life years (QALYs) (22 articles; 67%) or disability-adjusted life years (DALYs) (4 articles; 12%). The most common health condition for which an intervention targets is overweight and obesity. Almost all school-based interventions were found to be cost-effective (30 articles; 81%). Conclusion Our review found evidence to support a number of cost-effective school-based interventions targeting NCDs focused on vaccination, routine physical activity, and supplement delivery interventions. Conversely, many classroom-based cognitive behavioral therapy for mental health and certain multi-component interventions for obesity were not found to be cost-effective.

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Section: Resultsmentioning

confidence: 99%

The cost-effectiveness of school-based interventions for chronic diseases: a systematic review

Lin,

Werner,

Alqunaiebet

et al. 2024

Cost Eff Resour Alloc

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“…The competing alternatives under investigation – care as usual in particular – should be detailed. The study’s perspective should be justified and the applied time horizon should capture relevant long-term costs and effects of preventive measures 9 , 11 . In this regard, it is important to stress the cost-effectiveness results of digital therapeutics despite the sometimes quite short time horizons applied.…”

Section: Discussionmentioning

confidence: 99%

“…Lifestyle interventions are thus valid strategies but the cost-effectiveness of various programmes and their drivers still need to be better documented. Staff labour cost is such an important driver, accounting for the larger part of lifestyle intervention costs and could thus be a potential target for improving cost-effectiveness 11 , for instance with the use of digital health interventions.…”

Section: Introductionmentioning

confidence: 99%

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

Willems,

Annemans,

Siopis

et al. 2023

npj Digit. Med.

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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.Registration: PROSPERO (CRD42021247845).

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“…The cost-effectiveness between groups, the smartphone apps group was highly cost-effective followed by mobile applications, while the supervised exercise treatment option was the least. The Feel Diabetes intervention (Feel4Diabetes) was cost-effective in high-income and low to middle-income countries, and cost-saving in the high-income countries under austerity measures following the financial crisis (33).…”

Section: Discussionmentioning

confidence: 99%

Cost Analysis of Mobile Technology and Supervised Exercise Training in Type 2 Diabetes Mellitus

Timurtaş,

Mate,

Kartal

et al. 2023

Türk Fizyoterapi Ve Rehabilitasyon Dergisi

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Amaç: Bu araştırmanın amacı, Tip-2 Diabetes Mellituslu (T2DM) kişilerin gözetimli egzersiz, akıllı telefon uygulaması ve akıllı saat kullanarak yaptıkları 12 haftalık egzersiz takibinin yapıldığı randomize kontrollü klinik çalışmanın maliyet analizinin yapılmasıdır. Yöntem: Denetimli egzersiz, akıllı telefon uygulaması ve akıllı saat yoluyla 12 hafta boyunca egzersiz uygulanan üç farklı T2DM grubu için Sosyal Sigortalar Kurumu tarafından yapılan ödemeler belirlenerek bütçe etkisi hesaplanmış ve maliyet etkinliği toplumsal bakış açısıyla hesaplanmıştır. Sonuç: Türk Lirası (TL) başına Kaliteye Ayarlanmış Yaşam Yıl (KAYY) değerleri denetimli egzersiz grubunda 14.863 TL; akıllı telefon uygulama grubunda 6056 TL, akıllı saat grubunda 7379 TL olarak bulundu. Maliyet etkinliği en yüksek olan yöntemin akıllı telefonla egzersiz uygulama yöntemi olduğu belirlendi. Maliyet analizinde KAYY değerlerindeki değişim denetimli egzersiz grubunda 0,11; akıllı telefon uygulama grubunda 0,12 ve akıllı saat grubunda 0,11 olarak hesaplandı. Tartışma: Maliyet etkinliği akıllı telefon uygulama grubunda yüksek, mobil uygulamalar grubunda orta ve denetimli egzersiz grubunda en düşük olup çalışmanın sonuçları literatür ile benzerlik göstermektedir.

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Cost-effectiveness analysis of a school- and community-based intervention to promote a healthy lifestyle and prevent type 2 diabetes in vulnerable families across Europe: the Feel4Diabetes-study

Cited by 4 publications

References 28 publications

The cost-effectiveness of school-based interventions for chronic diseases: a systematic review

The cost-effectiveness of school-based interventions for chronic diseases: a systematic review

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

Cost Analysis of Mobile Technology and Supervised Exercise Training in Type 2 Diabetes Mellitus

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