Cost-utility of an online education platform and diabetes personal health record: analysis over ten years

Scott Cunningham; Andrew Stoddart; Sarah H Wild; Nicholas Conway; Alastair Gray; Deborah J Wake

doi:10.1177/19322968211069172

Cost-utility of an online education platform and diabetes personal health record: analysis over ten years

Scott Cunningham^*, Andrew Stoddart, Sarah H Wild, Nicholas Conway, Alastair Gray, Deborah J Wake

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract

Background and aims: My Diabetes My Way (MDMW) is Scotland’s interactive
website and mobile app for people with diabetes and their caregivers. It contains
multimedia resources for diabetes education and offers access to electronic personal health records. This study aims to assess the cost-utility of MDMW compared to routine diabetes care in people with type 2 diabetes who do not use insulin.
Materials and methods: Analysis used the United Kingdom Prospective Diabetes
Study (UKPDS) Outcomes Model2. Clinical parameters of MDMW users (n=2,576) were compared with a matched cohort of individuals receiving routine care alone (n=11,628).
Matching criteria: age, diabetes duration, sex and socio-economic status. Impact on life expectancy, quality-adjusted life years (QALYs) and costs of treatment and
complications were simulated over ten years, including a 10% sensitivity analysis.
Results: MDMW cohort: 1,670 (64.8%) men; average age 64.3 years; duration of
diabetes 5.5 years. 906 (35.2%) women: average age 61.6; duration 4.7 years. The
cumulative mean QALY (95% CI) gain: 0.054 (0.044; 0.062) years. Mean difference in cost: -£118.72 (-£150.16; -£54.16) over ten years. Increasing MDMW costs (10%): - £50.49 (-£82.24; £14.14). Decreasing MDMW costs (10%): -£186.95 (-£218.53; - £122.51).
Conclusions: MDMW is ‘dominant’ over usual care (cost-saving and life improving) in supporting self-management in people with type 2 diabetes not treated with insulin. Wider use may result in significant cost savings through delay or reduction of long-term complications and improved QALYs in Scotland and other countries. MDMW may be among the most cost-effective interventions currently available to support diabetes.

Original language	English
Journal	Journal of Diabetes Science and Technology
Early online date	5 Jan 2022
DOIs	https://doi.org/10.1177/19322968211069172
Publication status	E-pub ahead of print - 5 Jan 2022

Keywords / Materials (for Non-textual outputs)

eHealth
education
health care delivery
health economics
information technology
medical informatics
self-management

Access to Document

10.1177/19322968211069172Licence: Creative Commons: Attribution Non-Commercial (CC-BY-NC)

CUNNINGHAM MANUSCRIPT 2Accepted author manuscript, 904 KB

1 Article

Impact on diabetes-related health outcomes using a digitally-enabled diabetes self-management platform in Somerset, UK: An interrupted time-series analysis
Baxter, M., Conway, N., Bickerton, A., Cunningham, S., Mackenzie, S. C., Dickson, J., Brodie, D., Sainsbury, C. & Wake, D. J., 25 Jun 2025, In: Primary Care Diabetes. 19, 4, p. 360-367 8 p.
Research output: Contribution to journal › Article › peer-review

Open Access
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Cite this

@article{7bfd9de837184ca0be88a67384b053f4,

title = "Cost-utility of an online education platform and diabetes personal health record: analysis over ten years",

abstract = "Background and aims: My Diabetes My Way (MDMW) is Scotland{\textquoteright}s interactive website and mobile app for people with diabetes and their caregivers. It contains multimedia resources for diabetes education and offers access to electronic personal health records. This study aims to assess the cost-utility of MDMW compared to routine diabetes care in people with type 2 diabetes who do not use insulin. Materials and methods: Analysis used the United Kingdom Prospective Diabetes Study (UKPDS) Outcomes Model2. Clinical parameters of MDMW users (n=2,576) were compared with a matched cohort of individuals receiving routine care alone (n=11,628). Matching criteria: age, diabetes duration, sex and socio-economic status. Impact on life expectancy, quality-adjusted life years (QALYs) and costs of treatment and complications were simulated over ten years, including a 10\% sensitivity analysis. Results: MDMW cohort: 1,670 (64.8\%) men; average age 64.3 years; duration of diabetes 5.5 years. 906 (35.2\%) women: average age 61.6; duration 4.7 years. The cumulative mean QALY (95\% CI) gain: 0.054 (0.044; 0.062) years. Mean difference in cost: -£118.72 (-£150.16; -£54.16) over ten years. Increasing MDMW costs (10\%): - £50.49 (-£82.24; £14.14). Decreasing MDMW costs (10\%): -£186.95 (-£218.53; - £122.51). Conclusions: MDMW is {\textquoteleft}dominant{\textquoteright} over usual care (cost-saving and life improving) in supporting self-management in people with type 2 diabetes not treated with insulin. Wider use may result in significant cost savings through delay or reduction of long-term complications and improved QALYs in Scotland and other countries. MDMW may be among the most cost-effective interventions currently available to support diabetes.",

keywords = "eHealth, education, health care delivery, health economics, information technology, medical informatics, self-management",

author = "Scott Cunningham and Andrew Stoddart and Wild, \{Sarah H\} and Nicholas Conway and Alastair Gray and Wake, \{Deborah J\}",

note = "Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work has been made possible from grant funding by the Scottish Government through the Scottish Diabetes Group and the NHS Scotland Technology Enabled Care Program. The funders were not involved in any aspect of the production of this article or in any decisions related to its submission for publication. None of the authors have been paid to write this article by any pharmaceutical or other agency. Dr Cunningham had full access to the data in the study and had final responsibility for the decision to submit for publication. Publisher Copyright: {\textcopyright} 2022 Diabetes Technology Society.",

year = "2022",

month = jan,

day = "5",

doi = "10.1177/19322968211069172",

language = "English",

journal = "Journal of Diabetes Science and Technology",

issn = "1932-2968",

publisher = "SAGE Publications",

}

TY - JOUR

T1 - Cost-utility of an online education platform and diabetes personal health record

T2 - analysis over ten years

AU - Cunningham, Scott

AU - Stoddart, Andrew

AU - Wild, Sarah H

AU - Conway, Nicholas

AU - Gray, Alastair

AU - Wake, Deborah J

N1 - Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work has been made possible from grant funding by the Scottish Government through the Scottish Diabetes Group and the NHS Scotland Technology Enabled Care Program. The funders were not involved in any aspect of the production of this article or in any decisions related to its submission for publication. None of the authors have been paid to write this article by any pharmaceutical or other agency. Dr Cunningham had full access to the data in the study and had final responsibility for the decision to submit for publication. Publisher Copyright: © 2022 Diabetes Technology Society.

PY - 2022/1/5

Y1 - 2022/1/5

N2 - Background and aims: My Diabetes My Way (MDMW) is Scotland’s interactive website and mobile app for people with diabetes and their caregivers. It contains multimedia resources for diabetes education and offers access to electronic personal health records. This study aims to assess the cost-utility of MDMW compared to routine diabetes care in people with type 2 diabetes who do not use insulin. Materials and methods: Analysis used the United Kingdom Prospective Diabetes Study (UKPDS) Outcomes Model2. Clinical parameters of MDMW users (n=2,576) were compared with a matched cohort of individuals receiving routine care alone (n=11,628). Matching criteria: age, diabetes duration, sex and socio-economic status. Impact on life expectancy, quality-adjusted life years (QALYs) and costs of treatment and complications were simulated over ten years, including a 10% sensitivity analysis. Results: MDMW cohort: 1,670 (64.8%) men; average age 64.3 years; duration of diabetes 5.5 years. 906 (35.2%) women: average age 61.6; duration 4.7 years. The cumulative mean QALY (95% CI) gain: 0.054 (0.044; 0.062) years. Mean difference in cost: -£118.72 (-£150.16; -£54.16) over ten years. Increasing MDMW costs (10%): - £50.49 (-£82.24; £14.14). Decreasing MDMW costs (10%): -£186.95 (-£218.53; - £122.51). Conclusions: MDMW is ‘dominant’ over usual care (cost-saving and life improving) in supporting self-management in people with type 2 diabetes not treated with insulin. Wider use may result in significant cost savings through delay or reduction of long-term complications and improved QALYs in Scotland and other countries. MDMW may be among the most cost-effective interventions currently available to support diabetes.

AB - Background and aims: My Diabetes My Way (MDMW) is Scotland’s interactive website and mobile app for people with diabetes and their caregivers. It contains multimedia resources for diabetes education and offers access to electronic personal health records. This study aims to assess the cost-utility of MDMW compared to routine diabetes care in people with type 2 diabetes who do not use insulin. Materials and methods: Analysis used the United Kingdom Prospective Diabetes Study (UKPDS) Outcomes Model2. Clinical parameters of MDMW users (n=2,576) were compared with a matched cohort of individuals receiving routine care alone (n=11,628). Matching criteria: age, diabetes duration, sex and socio-economic status. Impact on life expectancy, quality-adjusted life years (QALYs) and costs of treatment and complications were simulated over ten years, including a 10% sensitivity analysis. Results: MDMW cohort: 1,670 (64.8%) men; average age 64.3 years; duration of diabetes 5.5 years. 906 (35.2%) women: average age 61.6; duration 4.7 years. The cumulative mean QALY (95% CI) gain: 0.054 (0.044; 0.062) years. Mean difference in cost: -£118.72 (-£150.16; -£54.16) over ten years. Increasing MDMW costs (10%): - £50.49 (-£82.24; £14.14). Decreasing MDMW costs (10%): -£186.95 (-£218.53; - £122.51). Conclusions: MDMW is ‘dominant’ over usual care (cost-saving and life improving) in supporting self-management in people with type 2 diabetes not treated with insulin. Wider use may result in significant cost savings through delay or reduction of long-term complications and improved QALYs in Scotland and other countries. MDMW may be among the most cost-effective interventions currently available to support diabetes.

KW - eHealth

KW - education

KW - health care delivery

KW - health economics

KW - information technology

KW - medical informatics

KW - self-management

U2 - 10.1177/19322968211069172

DO - 10.1177/19322968211069172

M3 - Article

SN - 1932-2968

JO - Journal of Diabetes Science and Technology

JF - Journal of Diabetes Science and Technology

ER -

Cost-utility of an online education platform and diabetes personal health record: analysis over ten years

Abstract

Keywords / Materials (for Non-textual outputs)

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Research output

Impact on diabetes-related health outcomes using a digitally-enabled diabetes self-management platform in Somerset, UK: An interrupted time-series analysis

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