Kelly Ryan Charles, Holt Richard I G, Price Hermione, Phiri Peter, Cummings Michael, Ali Amar, Patel Mayank, Barnard Ethan, Allard Sharon, Hunter Victoria, Rojkova Jana, Bolger Clare, Georgieva Daniela, Schinz Maren, Rothenbühler Martina, Lizoain Aritz, Barnard-Kelly Katharine
Spotlight Consultations Ltd, Portsmouth, UK.
Southern Health NHS Foundation Trust, Southampton, UK.
J Diabetes Sci Technol. 2025 Jan 30:19322968241310879. doi: 10.1177/19322968241310879.
Burnout affects >50% of physicians and nurses. Spotlight-AQ is a personalized digital health platform designed to improve routine diabetes visits. We assessed cost-effectiveness, visit length, and association with health care professional (HCP) burnout.
Complete case within-trial cost-effectiveness analysis embedded within a multicenter, parallel-group randomized controlled trial. Adults with diabetes were recruited from primary and secondary care. Intervention group participants completed the Spotlight-AQ pre-clinic assessment before each routine visit. Health status was assessed with EQ-5D-5L to calculate quality-adjusted life years (QALYs). Client Service Receipt Inventory measured downstream resource use. Total costs and QALYs were calculated using baseline-controlled seemingly unrelated regression with bootstrapping. Haemoglobin (HbA) data were collected. Health care professionals completed the Maslach Burnout Inventory at baseline and study end.
A total of 98 adults (49 intervention) and 18 HCPs participated. Total costs: £243 (US$310) intervention arm versus £230 (US$293) control arm; incremental cost: £13 (US$16). Total QALYs: 0.362 intervention arm and 0.358 control arm, with an incremental QALY: 0.004. Spotlight-AQ intervention dominated usual care with a 68% probability of cost-effectiveness at a threshold of £30 000 (US$38 294) per QALY gained. Health care professionals reported reduced burnout, emotional exhaustion, depersonalization, and a greater sense of personal achievement. Doctors are more so than nurses.
Spotlight-AQ has demonstrated cost-effective while delivering improved care and reduced HCP burnout.
ISRCTN15511689, registration date: November 1, 2021.
职业倦怠影响超过50%的医生和护士。Spotlight - AQ是一个个性化数字健康平台，旨在改善糖尿病常规诊疗。我们评估了其成本效益、诊疗时长以及与医护人员职业倦怠的关联。
在一项多中心、平行组随机对照试验中进行完整病例的试验内成本效益分析。从初级和二级医疗保健机构招募成年糖尿病患者。干预组参与者在每次常规诊疗前完成Spotlight - AQ诊所前评估。使用EQ - 5D - 5L评估健康状况以计算质量调整生命年（QALY）。客户服务收据清单测量下游资源使用情况。使用基线对照的看似不相关回归和自抽样法计算总成本和QALY。收集血红蛋白（HbA）数据。医护人员在基线和研究结束时完成马氏职业倦怠量表。
共有98名成年人（49名干预组）和18名医护人员参与。总成本：干预组243英镑（310美元），对照组230英镑（293美元）；增量成本：13英镑（16美元）。总QALY：干预组0.362，对照组0.358，增量QALY：0.004。Spotlight - AQ干预在每获得一个QALY的阈值为30000英镑（38294美元）时，以68%的成本效益概率优于常规护理。医护人员报告职业倦怠、情感耗竭、去个性化程度降低，个人成就感增强。医生比护士更明显。
Spotlight - AQ已证明具有成本效益，同时提供了更好的护理并减少了医护人员的职业倦怠。
ISRCTN15511689，注册日期：2021年11月1日。
