Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Dec 17, 2018
Open Peer Review Period: Dec 19, 2018 - Feb 6, 2019
Date Accepted: May 17, 2019
(closed for review but you can still tweet)
The cost-effectiveness of digital health interventions on the management of cardiovascular diseases: A systematic review
ABSTRACT
Background:
Healthcare industry has entered the era of digital health. With the advancement in information technologies and mobile Internet, real-time monitoring and interventions are provided for management of high burden health problems such as cardiovascular diseases (CVDs). The impact of digital health interventions (DHIs) on cost-effective management of CVDs have been examined in literature using the decision analytic model-based health technology assessment (HTA) approach.
Objective:
The aim of this study was to perform a systematical review on decision analytic model-based studies evaluating the cost-effectiveness of DHIs on the management of CVDs.
Methods:
A literature research was conducted in Medline, Embase, CINAHL Complete, PsycINFO, Scopus, Web of Science, Center for Review and Dissemination, and Institute for IEEE Xplore, for paper published between 2001 and 2018. Studies were included if the following of criteria were met: (1) English articles, (2) DHIs that promoted clinical practitioners’ intervention and had impact on patients’ cardiovascular conditions, (3) studies that were modelling works with health economic outcomes of DHIs for CVDs, (4) studies that have a comparative group for assessment, and (5) full economic evaluations including cost-effectiveness analysis, cost-utility analysis, cost-benefit analysis, and cost-consequence analysis.
Results:
Fifteen studies met the defined criteria and were included in this systematic review. Heart failure and stroke were two frequent CVDs managed with DHIs. DHIs included telemedicine (telephone/mobile phone support, videoconferencing system and telestroke network) and wearable devices. The DHIs gained higher quality-adjusted life-years (QALYs) or improved clinical outcomes when compared with usual care in CVD management in all 15 studies. The DHIs were cost-saving in 5 studies, and incurred additional total cost in 10 studies. The cost-effectiveness of DHIs with higher total cost was subject to the willingness-to-pay threshold.
Conclusions:
This is the first systematic review of decision model-based cost-effectiveness analyses of DHIs on the management of CVDs. Findings from this review showed that there are few cost-effectiveness analyses of DHIs for CVDs in the literature. The DHIs improved QALYs gain or clinical outcomes of CVDs, and most of the DHIs incurred additional total cost when compared with usual care. Clinical Trial: N.A.
Citation
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Copyright
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