Cost-effectiveness of Digital Tools for Behavior Change Interventions Among People With Chronic Diseases: Systematic Review (Preprint)

Abstract

BACKGROUND Chronic diseases contribute to the largest burden of disease worldwide, having negative impacts on the patients themselves and their family members. Modifiable behavioural risk factors (smoking, overconsuming alcohol, and unhealthy diets) cause worse health outcomes among people with chronic diseases such as cardiovascular diseases, diabetes, chronic obstructive pulmonary disease and cerebrovascular diseases. With smartphones and easy access to the internet, it is possible to use information technology to better one’s health. OBJECTIVE To investigate the cost-effectiveness of digital health interventions for behavioural change among people with chronic diseases METHODS This is a systematic review of published studies on the cost-effectiveness of using digital tools for behavioural change among people with chronic diseases. Economic evaluations using digital tools were included if the target population comprised adult people with chronic diseases, and the intervention aimed at behaviour change. Two researchers conducted independent screening according to the eligibility criteria. RESULTS A total of 20 studies were included after the final screening, published from 2003 to 2021. All studies were conducted in high-income countries. Telephone, text messaging, mobile health applications and website/online were digital tools for behaviour change communication. Almost all studies (8/9) with full economic evaluation found digital health interventions to be cost-effective. A majority of studies (6/11) with partial economic evaluation concluded that digital health intervention was cost-saving. Most studies (17/20) used a healthcare payer perspective for economic analysis. CONCLUSIONS Digital health interventions for behavioural change among people with chronic diseases are cost-effective in high-income settings and has the potential to be cost-effective in low and middle-income countries (LMICs). As all studies in this review were for high-income countries, more studies are needed for LMICs. Scaling up digital health interventions for chronic diseases in high-income and LMICs is possible.