Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Jun 28, 2021
Date Accepted: Aug 1, 2021
Comparing the costs of paediatric weight management through mHealth to face-to-face care
ABSTRACT
Background:
Mobile health (mHealth) may improve paediatric weight management capacity, geographical reach for services, and overcome barriers to attending physical appointments by utilising ubiquitous devices such as smartphones and tablets, but the field remains an emerging research area with some evidence for effectiveness but no literature describing economic evaluations.
Objective:
We aimed to assess the economic viability of delivering a mHealth approach as an alternative to standard multidisciplinary care, by assessing the direct costs incurred within treatment arms during a non-inferiority randomised controlled trial (RCT).
Methods:
A digitally delivered (via smartphone app) maintenance phase of a paediatric weight management programme was developed iteratively with patients and families using evidence-based approaches. We undertook a micro-costing exercise and budget impact analysis to assess the costs of delivery from the perspective of the publicly funded healthcare system. Resource use was captured alongside a RCT, and we used a micro-costing approach to estimate costs associated with staff time and resources for service delivery per participant.
Results:
We estimated the mean direct cost per adolescent attending usual care at €142 (SD 23.7) while the cost per adolescent in the mHealth group was €722 (SD 221.1), with variation depending on the number of weeks of treatment completed. The budget impact for offering this approach to all newly referred patients in a one year period was estimated at €59,046 using the delivery approach assessed. The main driver of costs in the mHealth arm the need for health professional monitoring and support for patients on a weekly basis.
Conclusions:
This mHealth approach was more costly than usual care, although modifications to the intervention may offer opportunities to reduce the mHealth costs. The need for monitoring and support from healthcare professionals was not eliminated using this model of delivery. Further research is needed to explore the cost-effectiveness and economic impact on families and from a wider societal perspective. Clinical Trial: NCT01804855
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