Pediatric weight management through mHealth compared to face-to-face care: cost analysis of a randomized control trial
journal contributionposted on 2022-01-14, 14:46 authored by Louise Tully, Jan SorensenJan Sorensen, Grace O'MalleyGrace O'Malley
Background: Mobile health (mHealth) may improve pediatric weight management capacity and the geographical reach of services, and overcome barriers to attending physical appointments using ubiquitous devices such as smartphones and tablets. This field remains an emerging research area with some evidence of its effectiveness; however, there is a scarcity of literature describing economic evaluations of mHealth interventions.
Objective: We aimed to assess the economic viability of using an mHealth approach as an alternative to standard multidisciplinary care by evaluating the direct costs incurred within treatment arms during a noninferiority randomized controlled trial (RCT).
Methods: A digitally delivered (via a smartphone app) maintenance phase of a pediatric weight management program was developed iteratively with patients and families using evidence-based approaches. We undertook a microcosting exercise and budget impact analysis to assess the costs of delivery from the perspective of the publicly funded health care system. Resource use was analyzed alongside the RCT, and we estimated the costs associated with the staff time and resources for service delivery per participant.
Results: In total, 109 adolescents participated in the trial, and 84 participants completed the trial (25 withdrew from the trial). We estimated the mean direct cost per adolescent attending usual care at €142 (SD 23.7), whereas the cost per adolescent in the mHealth group was €722 (SD 221.1), with variations depending on the number of weeks of treatment completion. The conversion rate for the reference year 2013 was $1=€0.7525. The costs incurred for those who withdrew from the study ranged from €35 to €681, depending on the point of dropout and study arm. The main driver of the costs in the mHealth arm was the need for health professional monitoring and support for patients on a weekly basis. The budget impact for offering the mHealth intervention to all newly referred patients in a 1-year period was estimated at €59,046 using the assessed approach.
Conclusions: This mHealth approach was substantially more expensive than usual care, although modifications to the intervention may offer opportunities to reduce the mHealth costs. The need for monitoring and support from health care professionals (HCPs) was not eliminated using this delivery model. Further research is needed to explore the cost-effectiveness and economic impact on families and from a wider societal perspective.
ClinicalTrials.gov NCT01804855; https://clinicaltrials.gov/ct2/show/NCT01804855
RCSI University of Medicine and Health Sciences - StAR program (grant 2151)
Health Research Board (HRB) SPHeRE training program (SPHeRE/2013/1)
Children’s Fund for Health & National Children’s Research Centre of Ireland (PAC11-58)
CommentsThe original article is available at https://mhealth.jmir.org/
Published CitationTully L, Sorensen J, O'Malley G. Pediatric weight management through mHealth compared to face-to-face care: cost analysis of a randomized control trial. JMIR Mhealth Uhealth. 2021;9(9):e31621.
Publication Date28 June 2021
- School of Physiotherapy
- Health Outcomes Research Centre
- Health Professions Education
- Population Health and Health Services
PublisherJMIR Publications Inc.
- Published Version (Version of Record)