Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Dec 9, 2019
Date Accepted: Jun 3, 2020
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Changing Health Behavior of Patients with Cardiovascular Disease Through an eHealth Intervention in Three Different Countries: Cost-Effectiveness Assessment of the Do CHANGE 2 Randomized Controlled Trial
ABSTRACT
Background:
During the last decades, preventing the development of cardiovascular disease has become mainstay for reducing cardiovascular morbidity and mortality. It has been suggested that interventions should focus more on committed approaches of self-care, such as eHealth techniques.
Objective:
This study aims to provide evidence to understand the financial consequences of the Do CHANGE intervention, a multi-site randomized controlled trial to change health behavior in patients with cardiovascular diseases.
Methods:
The cost-effectiveness analysis of the Do CHANGE intervention was assessed with the Monitoring and Assessment Framework for the European Innovation Partnership on Active and Healthy Ageing (MAFEIP) tool, based on a Markov model of five health states. Two type of costs were considered for both study groups: (1) healthcare costs (including costs associated with the time spent by healthcare professionals on service provision, consultations, etc. and those associated unplanned hospitalizations), and (2) societal costs attributed to time spent by patients and informal caregivers in each group.
Results:
The results show that the Do CHANGE 2 intervention was less costly in Spain and more costly in the Netherlands and Taiwan. Compared with usual care, the effectiveness of the Do CHANGE 2 program in terms of quality-adjusted life-year (QALY) gains was slightly higher in the Netherlands and lower in Spain and Taiwan.
Conclusions:
In general, we found that the incremental cost-effectiveness was highly heterogeneous and that strongly varies depending on the country where the intervention was applied. Taking the costs and effectiveness into account, the Do CHANGE intervention would only be recommended to be implemented in Spain, where it would allow to save financial costs taken into account the costs and the effect of the intervention. Clinical Trial: NCT03178305
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