Cost-Effectiveness of Digital Health Interventions for Asthma or COPD: Systematic Review

IF 6.3 2区医学 Q1 ALLERGY Clinical and Experimental Allergy Pub Date : 2024-08-12 DOI:10.1111/cea.14547

Marta Alexandra Martins Ferreira, Adalberto Fernandes dos Santos, Bernardo Sousa-Pinto, Luís Taborda-Barata

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Abstract

Objective

Digital interventions such as remote monitoring of symptoms and physiological measurements have the potential to reduce the economic burden of asthma and chronic obstructive pulmonary disease (COPD) but their cost-effectiveness remains unclear. This systematic review of randomised controlled trials (RCT) aims to assess whether digital health interventions can be cost-effective in these patients.

Design

Systematic review of RCTs. Study quality was assessed using RoB2 tool.

Data Sources

Systematic search in three databases: PubMed, Scopus and Web of Science.

Eligibility Criteria

Studies were eligible if they were RCTs with health economic evaluations assessing participants with asthma and/or COPD and comparing a digital health intervention to standard of care.

Results

We included 35 RCTs, of which 21 were related to COPD, 13 to asthma and one to both diseases. Overall, studies assessed four categories of digital health interventions: (i) Electronic patient diaries (n = 4), (ii) real-time monitoring (n = 19), (iii) teleconsultations (n = 6) and (iv) others (n = 6). Eleven studies performed a full economic evaluation analysis, while 24 studies performed a partial economic analysis. Most studies involving real-time monitoring or teleconsultations presented economic results in favour of digital health interventions (indicating them to be cost-effective or less expensive than the standard of care). Mixed results were obtained for electronic patient diaries. In the studies that conducted a full economic analysis, the incremental cost-effectiveness ratio (ICER) ranged from 3530,93€/QALY and 286,369,28€/QALY. In the studies that conducted a partial economic analysis, the cost differences between the intervention group and the control group ranged from 0,12€ and 85,217,86€. Half studies with low risk of bias concluded that the intervention was economically favourable.

Conclusion

Although costs varied based on intervention type, follow-up period and country, most studies report digital health interventions to be affordable or associated with decreased costs.

Trial Registration

PROSPERO: CRD42023439195

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哮喘或慢性阻塞性肺病数字健康干预的成本效益：系统性综述》。

目的：远程监测症状和生理测量等数字化干预措施有可能减轻哮喘和慢性阻塞性肺病（COPD）的经济负担，但其成本效益仍不明确。本研究对随机对照试验（RCT）进行了系统回顾，旨在评估数字健康干预措施对这些患者是否具有成本效益：设计：对随机对照试验进行系统回顾。使用 RoB2 工具评估研究质量：在三个数据库中进行系统检索：PubMed、Scopus 和 Web of Science：对哮喘和/或慢性阻塞性肺病患者进行评估，并将数字健康干预措施与标准护理措施进行比较的 RCT 研究均符合条件：我们纳入了 35 项研究，其中 21 项与慢性阻塞性肺病有关，13 项与哮喘有关，1 项与两种疾病都有关。总体而言，研究评估了四类数字健康干预措施：(i) 电子患者日记（4 项），(ii) 实时监测（19 项），(iii) 远程会诊（6 项），(iv) 其他（6 项）。11 项研究进行了全面的经济评估分析，24 项研究进行了部分经济分析。大多数涉及实时监控或远程会诊的研究都得出了有利于数字医疗干预措施的经济结果（表明这些措施具有成本效益或成本低于标准护理）。电子病历的研究结果不一。在进行全面经济分析的研究中，增量成本效益比（ICER）介于 3530.93 欧元/QALY 和 286369.28 欧元/QALY 之间。在进行部分经济分析的研究中，干预组与对照组之间的成本差异介于 0.12 欧元与 85,217,86 欧元之间。半数偏倚风险较低的研究认为，干预措施在经济上是有利的：尽管成本因干预类型、随访时间和国家而异，但大多数研究报告称，数字健康干预是可负担得起的，或与成本降低有关：试验注册：PROCROPERO：CRD42023439195。

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来源期刊

Clinical and Experimental Allergy 医学-过敏

CiteScore

10.40

自引率

9.80%

发文量

189

审稿时长

3-8 weeks

期刊介绍： Clinical & Experimental Allergy strikes an excellent balance between clinical and scientific articles and carries regular reviews and editorials written by leading authorities in their field. In response to the increasing number of quality submissions, since 1996 the journals size has increased by over 30%. Clinical & Experimental Allergy is essential reading for allergy practitioners and research scientists with an interest in allergic diseases and mechanisms. Truly international in appeal, Clinical & Experimental Allergy publishes clinical and experimental observations in disease in all fields of medicine in which allergic hypersensitivity plays a part.