为埃塞俄比亚结核病治疗中采用有区别护理的数字依从性技术的流行病学和经济影响建模

Lara Goscé, Amare Worku Tadesse, Nicola Foster, Kristian Van Kalmthout, Job van Rest, jense .vanderwal, Martin Harker, Norma Madden, Tofik Abdurhman, Demekech Gadissa, Ahmed Bedru, Tanyaradzwa Nicolette Dube, Jason Alacapa, Andrew Mganga, Natasha Deyanova, Salome Charalambous, Taye Letta, Degu Jerene, Richard White, Katherine Fielding, Rein M G J Houben, Christopher Finn McQuaid
{"title":"为埃塞俄比亚结核病治疗中采用有区别护理的数字依从性技术的流行病学和经济影响建模","authors":"Lara Goscé, Amare Worku Tadesse, Nicola Foster, Kristian Van Kalmthout, Job van Rest, jense .vanderwal, Martin Harker, Norma Madden, Tofik Abdurhman, Demekech Gadissa, Ahmed Bedru, Tanyaradzwa Nicolette Dube, Jason Alacapa, Andrew Mganga, Natasha Deyanova, Salome Charalambous, Taye Letta, Degu Jerene, Richard White, Katherine Fielding, Rein M G J Houben, Christopher Finn McQuaid","doi":"10.1101/2024.07.30.24310024","DOIUrl":null,"url":null,"abstract":"Background\nDigital adherence technologies (DATs) with associated differentiated care are potential tools to improve tuberculosis (TB) treatment outcomes and reduce associated costs for both patient and healthcare providers. However, the balance between epidemiological and economic benefits remains unclear. Here, we used data from a large trial (PACTR202008776694999) to estimate the potential long – term epidemiological and economic impact of DAT interventions in Ethiopia.\nMethods\nWe developed a compartmental transmission model for TB, calibrated to Ethiopia and parameterised with patient and provider costs. We compared the epidemiological and economic impact of two DAT interventions, a digital pillbox and medication labels, to the current standard of care, assuming each was introduced at scale in 2023. We projected long – term TB incidence, mortality and costs to 2035, and conducted a threshold analysis to identify the maximum possible epidemiological impact of a DAT intervention by assuming 100% treatment completion for patients on DAT.\nFindings\nWe estimated small and uncertain epidemiological benefits of the pillbox intervention compared to the standard of care in Ethiopia, with a difference of – 0.4% ( – 1.1; +2.0) incident TB episodes and – 0.7% (– 2.2; +3.6) TB deaths. However, our analysis also found large total provider and patient cost savings [$163 ($118; $211) and $3 ($1; $5) million respectively over 2023 – 2035], translating to a 50.2% (35.9%; 65.2%) reduction in total cost of treatment. Results were similar for the medication label intervention. The maximum possible epidemiological impact a theoretical DAT intervention could achieve over the same timescale would be a 3% (1.4; 5.5%) reduction in incident TB and a 8.2% (4.4; 12.8) reduction in TB deaths. Interpretation\nDAT interventions, while showing limited epidemiological impact, could substantially reduce TB treatment costs for both patients and the healthcare provider.","PeriodicalId":501509,"journal":{"name":"medRxiv - Infectious Diseases","volume":"50 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Modelling the epidemiological and economic impact of digital adherence technologies with differentiated care for tuberculosis treatment in Ethiopia\",\"authors\":\"Lara Goscé, Amare Worku Tadesse, Nicola Foster, Kristian Van Kalmthout, Job van Rest, jense .vanderwal, Martin Harker, Norma Madden, Tofik Abdurhman, Demekech Gadissa, Ahmed Bedru, Tanyaradzwa Nicolette Dube, Jason Alacapa, Andrew Mganga, Natasha Deyanova, Salome Charalambous, Taye Letta, Degu Jerene, Richard White, Katherine Fielding, Rein M G J Houben, Christopher Finn McQuaid\",\"doi\":\"10.1101/2024.07.30.24310024\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background\\nDigital adherence technologies (DATs) with associated differentiated care are potential tools to improve tuberculosis (TB) treatment outcomes and reduce associated costs for both patient and healthcare providers. However, the balance between epidemiological and economic benefits remains unclear. Here, we used data from a large trial (PACTR202008776694999) to estimate the potential long – term epidemiological and economic impact of DAT interventions in Ethiopia.\\nMethods\\nWe developed a compartmental transmission model for TB, calibrated to Ethiopia and parameterised with patient and provider costs. We compared the epidemiological and economic impact of two DAT interventions, a digital pillbox and medication labels, to the current standard of care, assuming each was introduced at scale in 2023. We projected long – term TB incidence, mortality and costs to 2035, and conducted a threshold analysis to identify the maximum possible epidemiological impact of a DAT intervention by assuming 100% treatment completion for patients on DAT.\\nFindings\\nWe estimated small and uncertain epidemiological benefits of the pillbox intervention compared to the standard of care in Ethiopia, with a difference of – 0.4% ( – 1.1; +2.0) incident TB episodes and – 0.7% (– 2.2; +3.6) TB deaths. However, our analysis also found large total provider and patient cost savings [$163 ($118; $211) and $3 ($1; $5) million respectively over 2023 – 2035], translating to a 50.2% (35.9%; 65.2%) reduction in total cost of treatment. Results were similar for the medication label intervention. The maximum possible epidemiological impact a theoretical DAT intervention could achieve over the same timescale would be a 3% (1.4; 5.5%) reduction in incident TB and a 8.2% (4.4; 12.8) reduction in TB deaths. Interpretation\\nDAT interventions, while showing limited epidemiological impact, could substantially reduce TB treatment costs for both patients and the healthcare provider.\",\"PeriodicalId\":501509,\"journal\":{\"name\":\"medRxiv - Infectious Diseases\",\"volume\":\"50 1\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"medRxiv - Infectious Diseases\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1101/2024.07.30.24310024\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"medRxiv - Infectious Diseases","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1101/2024.07.30.24310024","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

摘要

背景数字依从性技术(DAT)与相关的差异化护理是改善结核病(TB)治疗效果并降低患者和医疗服务提供者相关成本的潜在工具。然而,流行病学和经济效益之间的平衡仍不明确。在此,我们利用一项大型试验(PACTR202008776694999)的数据来估算 DAT 干预措施在埃塞俄比亚可能产生的长期流行病学和经济影响。我们比较了两种 DAT 干预措施(数字药盒和药物标签)与现行医疗标准的流行病学和经济影响,假设每种干预措施都在 2023 年大规模引入。我们预测了到 2035 年的长期肺结核发病率、死亡率和成本,并进行了阈值分析,假设接受 DAT 治疗的患者 100% 完成治疗,从而确定 DAT 干预措施可能产生的最大流行病学影响。研究结果我们估计,与埃塞俄比亚的标准治疗相比,药盒干预措施的流行病学效益较小且不确定,其差异为肺结核发病率-0.4%(-1.1;+2.0)和肺结核死亡率-0.7%(-2.2;+3.6)。不过,我们的分析还发现,提供方和患者的总成本也有很大的节省[2023-2035 年分别为 1.63 亿美元(1.18 美元;2.11 美元)和 300 万美元(1 美元;500 万美元)],即治疗总成本减少了 50.2% (35.9%; 65.2%)。药物标签干预的结果与此类似。在相同的时间范围内,理论上的 DAT 干预措施可能产生的最大流行病学影响是:结核病发病率减少 3% (1.4; 5.5%) ,结核病死亡人数减少 8.2% (4.4; 12.8)。解释DAT干预措施虽然在流行病学方面的影响有限,但却能大幅降低患者和医疗服务提供者的结核病治疗成本。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
Modelling the epidemiological and economic impact of digital adherence technologies with differentiated care for tuberculosis treatment in Ethiopia
Background Digital adherence technologies (DATs) with associated differentiated care are potential tools to improve tuberculosis (TB) treatment outcomes and reduce associated costs for both patient and healthcare providers. However, the balance between epidemiological and economic benefits remains unclear. Here, we used data from a large trial (PACTR202008776694999) to estimate the potential long – term epidemiological and economic impact of DAT interventions in Ethiopia. Methods We developed a compartmental transmission model for TB, calibrated to Ethiopia and parameterised with patient and provider costs. We compared the epidemiological and economic impact of two DAT interventions, a digital pillbox and medication labels, to the current standard of care, assuming each was introduced at scale in 2023. We projected long – term TB incidence, mortality and costs to 2035, and conducted a threshold analysis to identify the maximum possible epidemiological impact of a DAT intervention by assuming 100% treatment completion for patients on DAT. Findings We estimated small and uncertain epidemiological benefits of the pillbox intervention compared to the standard of care in Ethiopia, with a difference of – 0.4% ( – 1.1; +2.0) incident TB episodes and – 0.7% (– 2.2; +3.6) TB deaths. However, our analysis also found large total provider and patient cost savings [$163 ($118; $211) and $3 ($1; $5) million respectively over 2023 – 2035], translating to a 50.2% (35.9%; 65.2%) reduction in total cost of treatment. Results were similar for the medication label intervention. The maximum possible epidemiological impact a theoretical DAT intervention could achieve over the same timescale would be a 3% (1.4; 5.5%) reduction in incident TB and a 8.2% (4.4; 12.8) reduction in TB deaths. Interpretation DAT interventions, while showing limited epidemiological impact, could substantially reduce TB treatment costs for both patients and the healthcare provider.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
期刊最新文献
Reactogenicity and immunogenicity against MPXV of the intradermal administration of Modified V Vaccinia Ankara compared to the standard subcutaneous route. A next generation CRISPR diagnostic tool to survey drug resistance in Human African Trypanosomiasis. Hospital-onset bacteraemia and fungaemia as a novel automated surveillance indicator: results from four European university hospitals Integration of Group A Streptococcus Rapid Tests with the Open Fluidic CandyCollect Device Deep Learning Models for Predicting the Nugent Score to Diagnose Bacterial Vaginosis
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1