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

Jaimon T Kelly; Lynette Law; Keshia R De Guzman; Ingrid J Hickman; Hannah L Mayr; Katrina L Campbell; Centaine L Snoswell; Daniel Erku

doi:10.1093/nutrit/nuad032

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

Jaimon T Kelly^*
, Lynette Law
, Keshia R De Guzman
, Ingrid J Hickman
, Hannah L Mayr
, Katrina L Campbell
, Centaine L Snoswell
, Daniel Erku

^*Corresponding author for this work

Research output: Contribution to journal › Review article › Research › peer-review

17 Citations (Scopus)

102 Downloads (Pure)

Abstract

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.

Original language	English
Pages (from-to)	1599-1611
Number of pages	13
Journal	Nutrition Reviews
Volume	81
Issue number	12
Early online date	4 Apr 2023
DOIs	https://doi.org/10.1093/nutrit/nuad032
Publication status	Published - 1 Dec 2023

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Cost-effectiveness of telehealth-delivered nutrition interventions a systematic review of randomized controlled trialsFinal published version, 851 KBLicence: CC BY-NC-ND

Cite this

@article{9f5155f835764faf8bca64adfa908fb0,

title = "Cost-effectiveness of telehealth-delivered nutrition interventions: a systematic review of randomized controlled trials",

abstract = "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.",

author = "Kelly, \{Jaimon T\} and Lynette Law and \{De Guzman\}, \{Keshia R\} and Hickman, \{Ingrid J\} and Mayr, \{Hannah L\} and Campbell, \{Katrina L\} and Snoswell, \{Centaine L\} and Daniel Erku",

note = "{\textcopyright} The Author(s) 2023. Published by Oxford University Press on behalf of the International Life Sciences Institute. Funding Information: Thank you to Kathryn Vitangcol for her assistance in updating the literature searches. J.T.K. was supported by a Postdoctoral Fellowship (grant no. 106081) from the National Heart Foundation of Australia. Publisher Copyright: {\textcopyright} 2023 The Author(s). Published by Oxford University Press on behalf of the International Life Sciences Institute.",

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doi = "10.1093/nutrit/nuad032",

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T1 - Cost-effectiveness of telehealth-delivered nutrition interventions: a systematic review of randomized controlled trials

AU - Kelly, Jaimon T

AU - Law, Lynette

AU - De Guzman, Keshia R

AU - Hickman, Ingrid J

AU - Mayr, Hannah L

AU - Campbell, Katrina L

AU - Snoswell, Centaine L

AU - Erku, Daniel

N1 - © The Author(s) 2023. Published by Oxford University Press on behalf of the International Life Sciences Institute. Funding Information: Thank you to Kathryn Vitangcol for her assistance in updating the literature searches. J.T.K. was supported by a Postdoctoral Fellowship (grant no. 106081) from the National Heart Foundation of Australia. Publisher Copyright: © 2023 The Author(s). Published by Oxford University Press on behalf of the International Life Sciences Institute.

PY - 2023/12/1

Y1 - 2023/12/1

N2 - 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.

AB - 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.

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U2 - 10.1093/nutrit/nuad032

DO - 10.1093/nutrit/nuad032

M3 - Review article

C2 - 37016937

SN - 0029-6643

VL - 81

SP - 1599

EP - 1611

JO - Nutrition Reviews

JF - Nutrition Reviews

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ER -

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

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

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