Full Title: Cost-effectiveness of complex knowledge transfer interventions based on ICTs over 5 years to improve health in patients with type 2 diabetes (INDICA-DOS)
Funded by: Instituto de Salud Carlos III (FIS PI16/00769)
Granted Amount: €50,215.00
Duration: 3 years (2017-2019)
Principal Investigator: Pedro Serrano Aguilar
Associated Researchers: Yolanda Ramallo Fariña, Lidia García Pérez, Montserrat Carmona Rodríguez, Armando Carrillo Domínguez, Marcos Estupiñán Ramírez, Ana Toledo Chávarri, Esperanza Escortell Mayor
Objectives:
Primary Objective: O1: Evaluate the cost-effectiveness of different complex knowledge transfer interventions to improve relevant health outcomes for patients, healthcare professionals, and funders in the SNS, both from a societal perspective and the SNS perspective.
Secondary Objectives: O2: Evaluate the acceptability of the complex knowledge transfer interventions and decision support from the perspectives of patients with type 2 diabetes and their family caregivers, as well as primary care healthcare professionals (doctors and nurses). O3: Evaluate adherence to the recommendations included in the knowledge transfer interventions for patients and healthcare professionals, and identify patient and professional characteristics associated with higher levels of adherence. O4: Analyze the associations between adherence (of patients and professionals) and health outcomes of patients (both objective and subjective), identifying patient profiles that obtain greater and lesser benefit. O5: Develop and evaluate an automated management support tool that combines information from the electronic health record on the care process, health outcomes, and healthcare resource utilization to inform resource management decisions (training, incentives, etc.) based on the professional performance of each Family Care Unit (FCU) and the health outcomes of people with diabetes in primary care.
Methods: Analysis of results from a community-based, multicenter, cluster-randomized controlled trial with 3 intervention and control arms. Subjects: 18-65 years with uncomplicated type 2 diabetes. Setting: Primary care in the Canary Islands. Analysis: O1: Cost-consequence and cost-effectiveness analysis estimating incremental cost ratios per QALY gained. Perspectives: SNS and societal. Markov Model: For long-term analysis, the CDC-RTI Diabetes Cost-Effectiveness Model will be used, utilizing literature and follow-up data. O2: Qualitative study with 8 focus groups (4 professionals, 4 patients). Structured and recorded sessions. Thematic analysis of transcripts using Atlas.ti. O3: Multivariate logistic regression to establish association between adherence and patient and professional characteristics. O4: Multivariate linear and logistic regressions to relate health and adherence. O5: Selection of extractable indicators from the electronic health record using Delphi in two rounds with primary care managers. Implementation of the tool in the electronic health record and evaluation through in-depth interviews and case studies.
Contact Person: Yolanda Ramallo Fariña (yolanda.ramallofarina@sescs.es)