The WISDOM self-management intervention: A cost-effectiveness analysis to support the transformation of type 2 diabetes care in England.
Diabet Med
; 39(10): e14928, 2022 10.
Article
in En
| MEDLINE
| ID: mdl-35900906
ABSTRACT
OBJECTIVES:
To assess the cost-effectiveness of the WISDOM self-management intervention for type 2 diabetes compared with care as usual.DESIGN:
We performed a difference-in-differences analysis to estimate differences in risk factors for diabetes complications between people in the WISDOM group (n = 25, 276) and a control group (n = 15, 272) using GP records. A decision analytic model was then used to extrapolate differences in risk factors into costs and outcomes in the long term.SETTING:
Participating GP practices in West Hampshire and Southampton, UK.PARTICIPANTS:
All people diagnosed with type 2 diabetes between January 1990 and March 2020 (n = 40,548).OUTCOMES:
Diabetes-related complications, quality-adjusted life years (QALYs) and costs to the English National Health Service at 5 years and lifetime.INTERVENTIONS:
The WISDOM intervention included risk stratification, self-management education programme to professionals and people with type 2 diabetes, and monitoring of key treatment targets.RESULTS:
WISDOM was associated with less atrial fibrillation [p = 0.001], albuminuria [p = 0.002] and blood pressure [p = 0.098]. Among all people in the intervention group, WISDOM led to 51 [95%CI 25; 76] QALYs gained and saved £278,036 [95%CI -631,900; 176,392] in the first 5 years after its implementation compared with care as usual. During those people' lifetime, WISDOM led to 253 [95%CI 75; 404] QALYs gained and cost saving of £126,380 [95%CI -1,466,008; 1,339,628]. The gains in QALYs were a result of reduced diabetes-related complications through improved management of the associated risk factors.CONCLUSIONS:
The WISDOM risk-stratification and education intervention for type 2 diabetes appear to be cost-effective compared to usual care by reducing diabetes complications.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Diabetes Mellitus, Type 2
/
Self-Management
Type of study:
Health_economic_evaluation
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Humans
Language:
En
Journal:
Diabet Med
Journal subject:
ENDOCRINOLOGIA
Year:
2022
Type:
Article
Affiliation country:
United kingdom