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dc.contributor.authorGarcía-Pérez, Lidia
dc.contributor.authorRamallo-Fariña, Yolanda
dc.contributor.authorVallejo-Torres, Laura
dc.contributor.authorRodríguez-Rodríguez, Leticia
dc.contributor.authorGonzález-Pacheco, Himar
dc.contributor.authorSantos-Hernández, Beatriz
dc.contributor.authorGarcía-Bello, Miguel Angel
dc.contributor.authorWägner, Ana Maria
dc.contributor.authorCarmona, Montserrat 
dc.contributor.authorSerrano-Aguilar, Pedro
dc.contributor.authorINDICA team
dc.date.accessioned2022-08-10T09:35:11Z
dc.date.available2022-08-10T09:35:11Z
dc.date.issued2022-04-08
dc.identifier.citationBMJ Open. 2022 Apr 8;12(4):e058049.es_ES
dc.identifier.urihttp://hdl.handle.net/20.500.12105/14882
dc.description.abstractObjective: To analyse the cost-effectiveness of multicomponent interventions designed to improve outcomes in type 2 diabetes mellitus (T2DM) in primary care in the Canary Islands, Spain, within the INDICA randomised clinical trial, from the public health system perspective. Design: An economic evaluation was conducted for the within-trial period (2 years) comparing the four arms of the INDICA study. Setting: Primary care in the Canary Islands, Spain. Participants: 2334 patients with T2DM without complications were included. Interventions: Interventions for patients (PTI), for primary care professionals (PFI), for both (combined intervention arm for patients and professionals, CBI) and usual care (UC) as a control group. Outcomes: The main outcome was the incremental cost per quality-adjusted life-years (QALY). Only the intervention and the healthcare costs were included. Analysis: Multilevel models were used to estimate results, and to measure the size and significance of incremental changes. Missed values were treated by means of multiple imputations procedure. Results: There were no differences between arms in terms of costs (p=0.093), while some differences were observed in terms of QALYs after 2 years of follow-up (p=0.028). PFI and CBI arms were dominated by the other two arms, PTI and UC. The differences between the PTI and the UC arms were very small in terms of QALYs, but significant in terms of healthcare costs (p=0.045). The total cost of the PTI arm (€2571, 95% CI €2317 to €2826) was lower than the cost in the UC arm (€2750, 95% CI €2506 to €2995), but this difference did not reach statistical significance. Base case estimates of the incremental cost per QALY indicate that the PTI strategy was the cost-effective option. Conclusions: The INDICA intervention designed for patients with T2DM and families is likely to be cost-effective from the public healthcare perspective. A cost-effectiveness model should explore this in the long term.es_ES
dc.description.sponsorshipThis study received financial support from the Spanish Ministry of Economy, Industry and Competitiveness (Instituto de Salud Carlos III), grants: ADE10/00032 and PI16/00769, jointly funded by the European Regional Development Fund (FEDER) ‘A way to make Europe’. The sponsor did not play any role in study design, collection, analysis and interpretation of data, drawing up of the report or the decision to submit the article for publication.es_ES
dc.language.isoenges_ES
dc.publisherBMJ Publishing Group es_ES
dc.type.hasVersionVoRes_ES
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/*
dc.subjectDabetes & endocrinologyes_ES
dc.subjectHealth economicses_ES
dc.subjectHealth informaticses_ES
dc.subjectPrimary carees_ES
dc.subjectQuality in health carees_ES
dc.subject.meshCluster Analysis es_ES
dc.subject.meshCost-Benefit Analysis es_ES
dc.subject.meshDiabetes Mellitus, Type 2 es_ES
dc.subject.meshHumans es_ES
dc.subject.meshPrimary Health Care es_ES
dc.subject.meshQuality of Life es_ES
dc.subject.meshQuality-Adjusted Life Years es_ES
dc.subject.meshSpain es_ES
dc.titleCost-effectiveness of multicomponent interventions in type 2 diabetes mellitus in a cluster randomised controlled trial: the INDICA studyes_ES
dc.typejournal articlees_ES
dc.rights.licenseAtribución-NoComercial 4.0 Internacional*
dc.identifier.pubmedID35396305es_ES
dc.format.volume12es_ES
dc.format.number4es_ES
dc.format.pagee058049es_ES
dc.identifier.doi10.1136/bmjopen-2021-058049es_ES
dc.contributor.funderMinisterio de Economía, Industria y Competitividad (España) es_ES
dc.contributor.funderInstituto de Salud Carlos III es_ES
dc.contributor.funderUnión Europea. Fondo Europeo de Desarrollo Regional (FEDER/ERDF) es_ES
dc.description.peerreviewedes_ES
dc.identifier.e-issn2044-6055es_ES
dc.relation.publisherversionhttps://doi.org/10.1136/bmjopen-2021-058049es_ES
dc.identifier.journalBMJ Openes_ES
dc.repisalud.centroISCIII::Agencia de Evaluación de Tecnologías Sanitariases_ES
dc.repisalud.institucionISCIIIes_ES
dc.rights.accessRightsopen accesses_ES
dc.relation.projectFISinfo:eu-repo/grantAgreement/ES/ADE10/00032es_ES
dc.relation.projectFISinfo:eu-repo/grantAgreement/ES/PI16/00769es_ES


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