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BACKGROUND

In South Africa, diabetes prevalence is expected to reach 5.4 million by 2030. In South Africa, diabetes-related complications severely impact not only patient health and quality of life but also the economy.

OBJECTIVE

The Diabetes Nurse Educator (DNE) study assessed the benefit of adding the MyDiaCare program to standard of care for managing patients with type 1 and type 2 diabetes in South Africa. An economic study was also performed to estimate the budget impact of adding MyDiaCare to standard of care for patients with type 2 diabetes older than 19 years treated in the South African private health care sector.

METHODS

The real-world DNE study was designed as an observational, retrospective, multicenter, single-group study. Eligible patients were older than 18 years and had at least 6 months of participation in the MyDiaCare program. The MyDiaCare program combines a patient mobile app and a health care professional platform with face-to-face visits with a DNE. The benefit of MyDiaCare was assessed by the changes in glycated hemoglobin (HbA) levels, the proportion of patients achieving clinical and biological targets, adherence to care plans, and satisfaction after 6 months of participating in the MyDiaCare program. A budget impact model was performed using data from the DNE study and another South African cohort of the DISCOVERY study to estimate the economic impact of MyDiaCare.

RESULTS

Between November 25, 2019, and June 30, 2020, a total of 117 patients (8 with type 1 diabetes and 109 with type 2 diabetes) were enrolled in 2 centers. After 6 months of MyDiaCare, a clinically relevant decrease in mean HbA levels of 0.6% from 7.8% to 7.2% was observed. Furthermore, 54% (43/79) of patients reached or maintained their HbA targets at 6 months. Most patients achieved their targets for blood pressure (53/79, 67% for systolic and 70/79, 89% for diastolic blood pressure) and lipid parameters (49/71, 69% for low-density-lipoprotein [LDL] cholesterol, 41/71, 58% for high-density-lipoprotein [HDL] cholesterol, and 59/71, 83% for total cholesterol), but fewer patients achieved their targets for triglycerides (32/70, 46%), waist circumference (12/68, 18%), and body weight (13/76, 17%). The mean overall adherence to the MyDiaCare care plan was 93%. Most patients (87/117, 74%) were satisfied with the MyDiaCare program. The net budget impact per patient with type 2 diabetes, older than 19 years, treated in the private sector using MyDiaCare was estimated to be approximately South African Rands (ZAR) 71,023 (US $4089) during the first year of introducing MyDiaCare.

CONCLUSIONS

The results of using MyDiaCare program, which combines digital tools for patients and health care professionals with DNE support, suggest that it may be a clinically effective and cost-saving solution for diabetes management in the South African private health care sector.

BACKGROUND

OBJECTIVE

METHODS

RESULTS

CONCLUSIONS

背景

在南非，预计到2030年糖尿病患病率将达到540万。在南非，糖尿病相关并发症不仅严重影响患者的健康和生活质量，还对经济造成影响。

目的

糖尿病护士教育者（DNE）研究评估了在南非将MyDiaCare项目添加到1型和2型糖尿病患者标准治疗方案中的益处。还进行了一项经济研究，以估计在南非私立医疗保健部门为19岁以上2型糖尿病患者将MyDiaCare添加到标准治疗方案中的预算影响。

方法

真实世界的DNE研究设计为一项观察性、回顾性、多中心、单组研究。符合条件的患者年龄在18岁以上，且参与MyDiaCare项目至少6个月。MyDiaCare项目将患者移动应用程序和医疗保健专业人员平台与糖尿病护士教育者的面对面访视相结合。通过糖化血红蛋白（HbA）水平的变化、达到临床和生物学目标的患者比例、对护理计划的依从性以及参与MyDiaCare项目6个月后的满意度来评估MyDiaCare的益处。使用DNE研究和DISCOVERY研究的另一个南非队列的数据进行预算影响模型分析，以估计MyDiaCare的经济影响。

结果

在2019年11月25日至2020年6月30日期间，共有117名患者（8名1型糖尿病患者和109名2型糖尿病患者）在2个中心入组。参与MyDiaCare项目6个月后，观察到平均HbA水平从7.8%临床相关地下降了0.6%，降至7.2%。此外，54%（43/79）的患者在6个月时达到或维持了HbA目标。大多数患者达到了血压目标（收缩压53/79，67%；舒张压70/79，89%）和血脂参数目标（低密度脂蛋白[LDL]胆固醇49/71，69%；高密度脂蛋白[HDL]胆固醇41/71，58%；总胆固醇59/71，83%），但达到甘油三酯目标（32/70，46%）、腰围目标（12/68，18%）和体重目标（13/76，17%）的患者较少。对MyDiaCare护理计划的总体平均依从率为93%。大多数患者（87/117，74%）对MyDiaCare项目满意。在引入MyDiaCare的第一年，在私立部门接受治疗且年龄大于19岁的2型糖尿病患者，使用MyDiaCare的每位患者的净预算影响估计约为71,023南非兰特（4089美元）。