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Economic evaluation of a multimodal intervention in pre-frail and frail older people with diabetes mellitus: the MID-FRAIL Project.

Published on May 25, 2020in Expert Review of Pharmacoeconomics & Outcomes Research1.828
· DOI :10.1080/14737167.2020.1766970
Luz María Peña Longobardo2
Estimated H-index: 2
(UCLM: University of Castilla–La Mancha),
Luz María Peña-Longobardo10
Estimated H-index: 10
(UCLM: University of Castilla–La Mancha)
+ 5 AuthorsLeocadio Rodríguez Mañas5
Estimated H-index: 5
Abstract
: Background: The aim of this study was to estimate the incremental cost-utility ratio (ICUR) of a multi-modal intervention in frail and pre-frail subjects aged ≥70 years with type-2 diabetes versus usual care group focused on quality-adjusted life years (QALYs) in different European countries.Methods: The MID-FRAIL study was a cluster randomized multicentre trial conducted in seven European countries. A cost-utility analysis was carried out based on this study, conducted from the perspective of the health care system with a time horizon of one year. Univariate and probabilistic analysis were carried out to test the robustness of the results.Results: The cost estimation showed the offsetting health effect of the intervention programme on total health care costs. The mean annual health care costs were 25% higher among patients in usual care. The mean incremental QALY gained per patient by the intervention group were 0.053 QALY compared with usual care practice.Conclusions: The MID-FRAIL intervention programme showed to be the dominant option in comparison with usual care practice. It saved costs to the health care system and achieved worthwhile health gains. This finding should encourage its implementation, at least, in the trial participant countries.Key words: diabetes; T2DM; frailty; older people, health care costs; cost-utility; economic evaluation; multimodal intervention.
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References58
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#1Gotaro Kojima (UCL: University College London)H-Index: 17
Abstract Background Although frailty of older people has been shown to be associated with numerous adverse health outcomes, evidence on healthcare costs associated with frailty is scarce. Methods Medline, Embase, PsycINFO, and AMED were electronically searched in January 2019 based on a protocol in accordance with the PRISMA statement using Medical Subjective Heading and free text terms, with explosion functions. Language restriction was not applied. Studies were considered if they were publishe...
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#2Olga Laosa (Foundation for Biomedical Research)H-Index: 7
Last. Sinclair AH-Index: 32
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Background: Type 2 diabetes, a highly prevalent chronic disease, is associated with increasing frailty and functional decline in older people. We aimed to evaluate the effectiveness of a multimodal intervention on functional performance in frail and pre‐frail participants aged ≥70 years with type 2 diabetes mellitus. Methods: The MID‐Frail study was a cluster‐randomized multicenter clinical trial conducted in 74 trial sites across seven European countries. The trial recruited 964 participants wh...
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#1Alvaro Casas-Herrero (ISCIII: Carlos III Health Institute)H-Index: 11
#2Ivan Anton-Rodrigo (Grupo México)H-Index: 1
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The benefit of physical exercise in ageing and particularly in frailty has been the aim of recent research. Moreover, physical activity in the elderly is associated with a decreased risk of mortality, of common chronic illnesses (i.e. cardiovascular disease or osteoarthritis) and of institutionalization as well as with a delay in functional decline. Additionally, very recent research has shown that, despite its limitations, physical exercise is associated with a reduced risk of dementia, Alzheim...
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#1Giuseppe LiottaH-Index: 31
#2F GilardiH-Index: 7
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#1Alan J. SinclairH-Index: 19
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: In our ageing society diabetes imposes a significant burden in terms of the numbers of people with the condition, diabetes-related complications including disability, and health and social care expenditure. Older people with diabetes can represent some of the more complex and difficult challenges facing the clinician working in different settings, and the recognition that we have only a relatively small (but increasing) evidence base to guide us in diabetes management is a limitation of our cu...
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ABSTRACTIntroduction: There is a growing need to evaluate the factors contributing to the increase in health expenditures, as well as the cost of medicines used in the treatment of Type 2 diabetes ...
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#1Afsana Afroz (Monash University)H-Index: 4
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Diabetes is one of the world’s most prevalent and serious non-communicable diseases (NCDs). It is a leading cause of death, disability and financial loss; moreover, it is identified as a major threat to global development. The chronic nature of diabetes and its related complications make it a costly disease. Estimating the total cost of an illness is a useful aid to national and international health policy decision making. The aim of this systematic review is to summarise the impact of the cost-...
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#1Godfrey Mutashambara Rwegerera (UB: University of Botswana)H-Index: 7
#2Thato Moshomo (Livingstone Hospital)H-Index: 2
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Abstract Background: Health-related quality of life (HRQOL) is an important aspect of diabetes mellitus care. The objective of the study was to determine the HRQOL of diabetes mellitus (DM) patients in Botswana as little known in Africa. Materials and methods : A cross-sectional study of 380 randomly selected DM patients in a tertiary clinic in Gaborone, Botswana was conducted to obtain Data on HRQOL and structured questionnaire was used to collect information on sociodemographic and clinical ch...
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#1André Hajek (UHH: University of Hamburg)H-Index: 13
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