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Published on December 30, 2015 | http://doi.org/10.5867/medwave.2015.11.6348

Education of people with type 2 diabetes through peers with diabetes: is it cost effective?

Educación de personas con diabetes tipo 2: ¿es costo-efectiva su implementación a través de pares con diabetes?

Lorena González , Jorge Federico Elgart, Juan José Gagliardino

Abstract

INTRODUCTION Inadequate quality of care provided to people with type 2 diabetes mellitus, generates a significant socioeconomic burden and a serious public health problem. Diabetes education through peers with diabetes is an alternative to that provided by professional educators (traditional education) which achieves non-inferior results. However, there is little evidence of cost-effectiveness of education trough peers over traditional education.

OBJECTIVE To evaluate cost-effectiveness of education of people with type 2 diabetes mellitus, during a year, by a team of professional educators (traditional education) versus education and support delivered by trained peers with diabetes.

METHODS Cost-effectiveness analysis based on a randomized prospective clinical study conducted in the city of La Plata, including 199 people with type 2 diabetes mellitus, divided in two groups:, one receiving traditional education and another receiving the same education but delivered by peer educators with type 2 diabetes mellitus. Change in glycosylated hemoglobin (HbA1c) was considered as a primary indicator of effectiveness and secondary indicators were others, such as body mass index, systolic blood pressure, diastolic blood pressure, fasting blood glucose, total cholesterol and triglyceride levels. The direct cost of each strategy was estimated based on resources used in the trial, evaluating three cost scenarios for peer education. The strength of the results was assessed by univariate sensitivity analysis.

RESULTS Cost per unit decrease (%) in HbA1c: traditional education: $2 621; peer education: $1 508, $1 779 y $2 071 for each of the three scenarios considered (scenario 1, scenario 2, scenario 3), respectively. For each $100 invested a decrease of 0.04% in the HbA1c with traditional education was achieved; and 0.07% in scenario 1; 0.06% in scenario 2 and 0.05% in scenario 3, with education delivered by peer educators. Sensitivity analysis showed the strength of the results.

CONCLUSION Education of type 2 diabetes mellitus patients through peers as a complement to control and treatment of the disease, is cost-effective compared to traditional education.

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This work is licensed under a Creative Commons Attribution 4.0 International License. Esta licencia permite el uso, distribución y reproducción del artículo en cualquier medio, siempre y cuando se otorgue el crédito correspondiente al autor del artículo y al medio en que se publica, en este caso, Medwave.

Authors

Lorena González

Centro de Endocrinología Experimental y Aplicada, Facultad de Ciencias Médicas Universidad Nacional de La Plata, La Plata, Argentina

lgonzalez@cenexa.org

Facultad de Ciencias Médicas, Universidad Nacional de La Plata, Avenida 60 Sin Número, La Plata, Argentina

Jorge Federico Elgart

Centro de Endocrinología Experimental y Aplicada, Facultad de Ciencias Médicas Universidad Nacional de La Plata, La Plata, Argentina

Juan José Gagliardino

Centro de Endocrinología Experimental y Aplicada, Facultad de Ciencias Médicas Universidad Nacional de La Plata, La Plata, Argentina

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Citation González L, Elgart JE, Gagliardino JJ. Education of people with type 2 diabetes through peers with diabetes: is it cost effective?. Medwave 2015;15(11):e6348 doi: 10.5867/medwave.2015.11.6348

Submission date 25/08/2015

Acceptance date 14/12/2015

Publication date 30/12/2015

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Not available at the moment.

Notes

Keywords

cost-effectiveness analysis, education, diabetes mellitus type 2

Origin and peer review

con revisión por tres pares revisores externos, a doble ciego

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