Cost-effectiveness of telehealth-delivered nutrition interventions: a systematic review of randomized controlled trials.

Autor:	Kelly JT; Centre for Online Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.; Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia., Law L; Bond University Nutrition and Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia.; La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia., De Guzman KR; Centre for Online Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.; Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia., Hickman IJ; Department of Nutrition and Dietetics, Princess Alexandra Hospital; and the School of Clinical Medicine, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia., Mayr HL; Bond University Nutrition and Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia.; Department of Nutrition and Dietetics, Princess Alexandra Hospital; and the School of Clinical Medicine, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.; Centre for Functioning and Health Research, Metro South Health, Queensland, Australia., Campbell KL; Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.; Healthcare Excellence and Innovation, Metro North Hospital and Health Service, Brisbane, Queensland, Australia.; Centre for Applied Health Economics, Griffith University, Nathan, Queensland; and the Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia., Snoswell CL; Centre for Online Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.; Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia., Erku D; Centre for Applied Health Economics, Griffith University, Nathan, Queensland; and the Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.
Jazyk:	angličtina
Zdroj:	Nutrition reviews [Nutr Rev] 2023 Nov 10; Vol. 81 (12), pp. 1599-1611.
DOI:	10.1093/nutrit/nuad032
Abstrakt:	Context: Telehealth-delivered nutrition interventions are effective in practice; however, limited evidence exists regarding their cost-effectiveness. Objective: To evaluate the cost-effectiveness of telehealth-delivered nutrition interventions for improving health outcomes in adults with chronic disease. Data Sources: PubMed, CENTRAL, CINAHL, and Embase databases were systematically searched from database inception to November 2021. Included studies were randomized controlled trials delivering a telehealth-delivered diet intervention conducted with adults with a chronic disease and that reported on cost-effectiveness or cost-utility analysis outcomes. Data Extraction: All studies were independently screened and extracted, and quality was appraised using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. Data Analysis: All extracted data were grouped into subcategories according to their telehealth modality and payer perspective, and were analyzed narratively. Results: Twelve randomized controlled trials comprising 5 phone-only interventions, 3 mobile health (mHealth), 2 online, and 1 each using a combination of phone-online or phone-mHealth interventions, were included in this review. mHealth interventions were the most cost-effective intervention in all studies. Across all telehealth interventions and cost analyses from health service perspectives, 60% of studies were cost-effective. From a societal perspective, however, 33% of studies reported that the interventions were cost-effective. Of the 10 studies using cost-utility analyses, 3 were cost saving and more effective, making the intervention dominant, 1 study reported no difference in costs or effectiveness, and the remaining 6 studies reported increased cost and effectiveness, meaning payers must decide whether this falls within an acceptable willingness-to-pay threshold for them. Quality of study reporting varied with between 63% to 92%, with an average of 77% of CHEERS items reported. Conclusion: Telehealth-delivered nutrition interventions in chronic disease populations appear to be cost-effective from a health perspective, and particularly mHealth modalities. These findings support telehealth-delivered nutrition care as a clinically beneficial, cost-effective intervention delivery modality. (© The Author(s) 2023. Published by Oxford University Press on behalf of the International Life Sciences Institute.)
Databáze:	MEDLINE
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