A Scoping Review of Economic Evaluations Alongside Randomised Controlled Trials of Home Monitoring in Chronic Disease Management
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Many countries have considered telemedicine and home monitoring of patients as a solution to the demographic challenges that health-care systems face. However, reviews of economic evaluations of telemedicine have identified methodological problems in many studies as they do not comply with guidelines. The aim of this study was to examine economic evaluations alongside randomised controlled trials of home monitoring in chronic disease management and hereby to explore the resources included in the programme costs, the types of health-care utilisation that change as a result of home monitoring and discuss the value of economic evaluation alongside randomised controlled trials of home monitoring on the basis of the studies identified. A scoping review of economic evaluations of home monitoring of patients with chronic disease based on randomised controlled trials and including information on the programme costs and the costs of equipment was carried out based on a Medline (PubMed) search. Nine studies met the inclusion criteria. All studies include both costs of equipment and use of staff, but there is large variation in the types of equipment and types of tasks for the staff included in the costs. Equipment costs constituted 16–73% of the total programme costs. In six of the nine studies, home monitoring resulted in a reduction in primary care or emergency contacts. However, in total, home monitoring resulted in increased average costs per patient in six studies and reduced costs in three of the nine studies. The review is limited by the small number of studies found and the restriction to randomised controlled trials, which can be problematic in this area due to lack of blinding of patients and healthcare professionals and the difficulty of implementing organisational changes in hospital departments for the limited period of a trial. Furthermore, our results may be based on assessments of older telemedicine interventions.
The authors thank Lise Kvistgaard Jensen and Claire Gudex, Odense University Hospital, for language editing of the manuscript and Christian Kronborg, COHERE, University of Southern Denmark for valuable comments on behalf of the Center for Innovative Medical Technology, Odense University Hospital.
KK contributed to development of the aim of the study, selection of the method for the review, literature search, assessment of the articles, charting of data, analysis and interpretation of data. MBDK contributed to development of the aim of the study, literature search, assessment of the articles, charting of data, analysis and interpretation of data.
Compliance with Ethical Standards
Conflict of interest
The authors Kristian Kidholm and Mie Borch Dahl Kristensen declare that there is no conflict of interest.
The review was funded by the Research Council at Odense University Hospital.
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