BMJ Open have published a study that investigates the cost-effectiveness of a telehealth intervention for primary care patients with raised cardiovascular risk (CVD).
The participants in the study were adults with a 10-year CVD risk ≥20%, as measured by the QRISK2 algorithm, with at least 1 modifiable risk factor.
The intervention compared usual care (control arm) with a series of up to 13 scripted, theory-led telehealth encounters with healthcare advisors, who supported participants to make behaviour change, use online resources, optimise medication and improve adherence.
641 participants were randomised — 325 to receive the telehealth intervention in addition to usual care and 316 to receive only usual care.
The intervention was associated with incremental mean per-patient National Health Service (NHS) costs of £138 and an incremental QALY (quality adjusted life years) gain of 0.012.
The incremental cost-effectiveness ratio was £10 859. Net monetary benefit at a cost-effectiveness threshold of £20 000 per QALY was £116 (95% CI −58 to 291), and the probability that the intervention was cost-effective at this threshold value was 0.77.
Intervention participants reported greater medication adherence, better access to support and satisfaction with treatment than did control participants.
Intervention participants reported small improvements in blood pressure and BMI, but not with respect to smoking or cholesterol.
The authors conclude that the trial provided weak evidence of a modest effect on 10-year CVD risk of the telehealth intervention. However, the intervention was estimated to be cost-effective (measured as a function of the ratio of incremental costs to incremental QALYs) from an NHS perspective after 12 months of trial follow-up.
The full study can be read here.