Cost-effectiveness of Shared Telemedicine Appointments in Young Adults With T1D: CoYoT1 Trial

Diabetes Care. 2019 Aug;42(8):1589-1592. doi: 10.2337/dc19-0363. Epub 2019 Jun 12.

Abstract

Objective: Young adults with type 1 diabetes (T1D) often struggle to achieve glycemic control and maintain routine clinic visits. We aimed to evaluate the societal cost-effectiveness of the Colorado young adults with T1D (CoYoT1) Clinic, an innovative care model of shared medical appointments through home telehealth.

Research design and methods: Patients self-selected into the CoYoT1 (N = 42) or usual care (N = 39) groups.

Results: Within the trial, we found no significant differences in 9-month quality-adjusted life; however, the control group had a larger decline from baseline in utility than the CoYoT1 group, indicating a quality of life (QoL) benefit of the intervention (difference in difference mean ± SD: 0.04 ± 0.09; P = 0.03). There was no significant difference in total costs. The CoYoT1 group had more study-related visits but fewer nonstudy office visits and hospitalizations. CONCLUSIONS: The CoYoT1 care model may help young adults with T1D maintain a higher QoL with no increase in costs.

Publication types

  • Controlled Clinical Trial
  • Pragmatic Clinical Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Ambulatory Care Facilities / economics
  • Ambulatory Care Facilities / organization & administration
  • Appointments and Schedules*
  • Blood Glucose / analysis
  • Colorado
  • Cost-Benefit Analysis
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / economics*
  • Diabetes Mellitus, Type 1 / therapy*
  • Female
  • Humans
  • Intention to Treat Analysis
  • Male
  • Quality of Life
  • Quality-Adjusted Life Years
  • Telemedicine / economics*
  • Telemedicine / organization & administration*
  • Telemedicine / standards
  • Young Adult

Substances

  • Blood Glucose