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针对伴有共病抑郁症的非依从性2型糖尿病患者的护士主导电话干预项目:成本后果与预算影响分析

Nurse-Led Telephone Program for Nonadherent to Treatment Type 2 Diabetics With Comorbid Depression: A Cost-Consequence and Budget Impact Analysis.

作者信息

Gómez-Barrera Manuel, Lozano-Del Hoyo María Luisa, Roy Juan Francisco, Fernández-Rodrigo María Teresa, Gómez-Torres Piedad, Blázquez-Ornat Isabel, Pérez-Calahorra Sofía, Samaniego Diaz de Corcuera Maria Esther, Ferrer-López Emilia, Ramón-Arbués Enrique

机构信息

Faculty of Health Sciences, San Jorge University, Villanueva de Gállego 50003, Zaragoza, Spain.

Pharmacoeconomics and Outcomes Research Iberia, PORIB, Madrid, Spain.

出版信息

J Nurs Manag. 2024 Nov 20;2024:9989080. doi: 10.1155/2024/9989080. eCollection 2024.

Abstract

To estimate the efficiency of a nurse-led telephone program for nonadherent to treatment Type 2 diabetics with comorbid depression (TELE-DD program). Secondary analysis of cost-consequence and budget impact, utilizing data from a randomized clinical trial conducted in the primary healthcare setting. The target population consisted of Type 2 diabetic patients with comorbid depression who were nonadherent to their pharmacological treatment. The average cost per controlled patient (glycated hemoglobin < 7%) and the incremental cost-effectiveness ratio were calculated. Similarly, the budgetary impact over 1 year of implementing this program in the region of reference of the randomized clinical trial was assessed. The number of controlled patients is higher in the TELE-DD group at 6, 12, and 18 months. The average cost per controlled patient was higher in the TELE-DD group than in the control group at 6 months (€160.31 vs. €49.79), but lower at 12 (€150.09 vs. €179.59) and 18 months (€209.22 vs. €376.88). The incremental cost-effectiveness ratio at 6, 12, and 18 months was €254.47, €143.65, and €177.46, respectively. The budget impact analysis revealed that implementing the TELE-DD program would result in a reduction of €721,940.68 in expenditure for the funder in the first year of application. A nurse-led telephone program for nonadherent Type 2 diabetics with comorbid depression is an efficient option in the management of healthcare resources. These results highlight the role of nursing in chronic patient management and the efficient use of healthcare resources. ClinicalTrials.gov Identifier: NCT04097483.

摘要

评估由护士主导的针对合并抑郁症的非依从性2型糖尿病患者的电话干预项目(TELE-DD项目)的效果。利用在基层医疗环境中进行的一项随机临床试验的数据进行成本-后果和预算影响的二次分析。目标人群为合并抑郁症且不依从药物治疗的2型糖尿病患者。计算了每位病情得到控制的患者(糖化血红蛋白<7%)的平均成本以及增量成本效益比。同样,评估了在随机临床试验的参照区域实施该项目1年的预算影响。在6个月、12个月和18个月时,TELE-DD组病情得到控制的患者数量更多。在6个月时,TELE-DD组每位病情得到控制的患者的平均成本高于对照组(160.31欧元对49.79欧元),但在12个月时较低(150.09欧元对179.59欧元),在18个月时也较低(209.22欧元对376.88欧元)。在6个月、12个月和18个月时的增量成本效益比分别为254.47欧元、143.65欧元和177.46欧元。预算影响分析表明,实施TELE-DD项目将使资助者在项目应用的第一年支出减少721,940.68欧元。对于合并抑郁症的非依从性2型糖尿病患者,由护士主导的电话干预项目是医疗资源管理中的一个有效选择。这些结果凸显了护理在慢性病患者管理以及医疗资源有效利用中的作用。临床试验注册号:NCT04097483。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d7cf/11919128/e4315e462ec6/JONM2024-9989080.001.jpg

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