Department of Psychiatry, University of California, San Francisco, Box 0884, San Francisco, CA 94143-0884, USA.
Department of Family and Community Medicine, University of California, San Francisco, Box 0900, San Francisco, CA 94143-0900, USA.
J Diabetes Complications. 2019 Nov;33(11):107416. doi: 10.1016/j.jdiacomp.2019.107416. Epub 2019 Aug 15.
This study evaluated the implementation costs of two group interventions, one focused on diabetes education (KnowIt) and one focused directly on diabetes distress (OnTrack), that reduced diabetes distress and HbA1C in adults with poorly controlled type 1 diabetes (T1DM) in the T1-REDEEM trial.
Resources used to provide interventions were enumerated using activity-based micro-costing methods. Costs were assigned to resources in 2017 US dollars. US median wage and benefit rates were used to calculate costs of staff time. Cost per unit change was calculated for diabetes distress and HbA1C.
For both interventions, per participant implementation costs were approximately $250 and cost per 1.0 percentage point (11 mmol/mol) change in HbA1C was $1400. Cost per unit change in diabetes distress was $364 for KnowIt and $335 for OnTrack. No statistically significant differences in costs were observed.
This is the first study to examine the costs of implementing interventions targeting diabetes distress in the context of T1DM. Both interventions had per participant implementation costs in the lower end of the range of previously examined diabetes self-management interventions ($219 to $5390). These inventions and their costs merit further attention because reducing diabetes distress may impact long term T1DM outcomes.
ClinicalTrials.govNCT02175732.
本研究评估了两项团体干预措施的实施成本，一项专注于糖尿病教育（KnowIt），另一项直接针对糖尿病困扰（OnTrack），这两项干预措施降低了 T1-REDEEM 试验中血糖控制不佳的 1 型糖尿病（T1DM）成年人的糖尿病困扰和 HbA1C。
使用基于活动的微观成本核算方法对干预措施所使用的资源进行了枚举。将成本分配到 2017 年的美元。使用美国中位数工资和福利率来计算员工时间成本。计算了糖尿病困扰和 HbA1C 每单位变化的成本。
对于这两种干预措施，每位参与者的实施成本约为 250 美元，HbA1C 每变化 1.0 个百分点（11mmol/mol）的成本为 1400 美元。KnowIt 组和 OnTrack 组的糖尿病困扰每单位变化的成本分别为 364 美元和 335 美元。成本没有观察到统计学上的显著差异。
这是第一项研究，在 T1DM 背景下研究针对糖尿病困扰的干预措施的实施成本。两种干预措施的每位参与者的实施成本都处于先前研究的糖尿病自我管理干预措施（219 美元至 5390 美元）的较低范围内。这些发明及其成本值得进一步关注，因为降低糖尿病困扰可能会影响长期 T1DM 结果。
ClinicalTrials.govNCT02175732。
