A Cost-Utility Analysis of LISTEN: Low-Intensity Mental Health Support via Telehealth-Enabled Network for Diabetes Distress

IF 6.2 2区医学 Q1 ECONOMICS

Value in Health Pub Date : 2026-09-01 Epub Date: 2026-05-15 DOI:10.1016/j.jval.2026.03.2250

Joahna Kevin Perez MHEcon, Mary Lou Chatterton PhD, Harish Raj Narandaran DrPH, Matthew P. Hamilton MSc, Edith Holloway PhD, Jane Speight PhD, Christel Hendrieckx, Cathrine Mihalopoulos PhD

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引用次数: 0

Abstract

Objectives

This study assessed the cost-effectiveness of Low-Intensity mental health Support via a Telehealth Enabled Network (LISTEN) for adults experiencing diabetes distress, facilitated by diabetes health professionals.

Methods

A within-trial cost-utility analysis included 428 participants randomized to either LISTEN (diabetes-specific problem-solving therapy) or usual care (web-based diabetes distress and generic mental health resources). Quality-adjusted life-years (QALYs) were derived using the Assessment of Quality of Life-4D. Costs were measured from health sector and societal perspectives using a self-reported resource use questionnaire. Incremental cost-effectiveness ratios were calculated and nonparametric bootstrapping estimated 95% confidence intervals. Costs were presented in Australian dollars (A$) for the 2021-2022 financial year.

Results

The mean direct cost of delivering LISTEN was A$262 per person. Over 6 months, the LISTEN group had higher total QALYs (0.024; 95% confidence intervals [CI] 0.007 to 0.041). Compared with usual care, mean health sector cost (−A$3271; 95% CI −A$5134 to A$1008) and societal cost (−A$3588; 95% CI −A$5913 to A$860) were lower, although these differences were not statistically significant. At a A$50 000 per QALY willingness-to-pay threshold, LISTEN was dominant with a 94% probability of being cost-effective from both perspectives. Findings should be interpreted cautiously given the substantial missing data.

Conclusion

LISTEN significantly improves health-related quality of life of adults with diabetes distress and is likely to be cost-effective. Point estimates show lower mean costs alongside QALY gains, but cost differences were not statistically significant.

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通过远程医疗网络为糖尿病患者提供低强度心理健康支持：LISTEN的成本效用分析

目的：本研究评估了LISTEN（通过远程医疗支持网络的低强度心理健康支持）在糖尿病健康专业人员的协助下对患有糖尿病困扰的成年人的成本效益。方法：试验内成本效用分析包括428名参与者，随机分为LISTEN（糖尿病特定问题解决疗法）或常规护理（基于网络的糖尿病困扰和一般心理健康资源）。质量调整生命年（QALYs）采用生活质量评估4d （aql - 4d）计算。使用自我报告的资源使用问卷，从卫生部门和社会角度衡量成本。计算增量成本-效果比（ICERs），非参数自举估计95%置信区间。2021-22财政年度的成本以澳元（A$）表示。结果：提供LISTEN的平均直接成本为每人262澳元。6个月后，LISTEN组有更高的总质量年（0.024;95% CI 0.007至0.041）。与常规护理相比，平均卫生部门成本（- 3,271美元；95% CI - 5,134至1,008澳元）和社会成本（- 3,588美元；95% CI - 5,913至860澳元）较低，尽管这些差异没有统计学意义。在每个QALY支付意愿阈值为50,000澳元的情况下，LISTEN以94%的概率从两个角度来看都具有成本效益。鉴于大量数据缺失，应谨慎解释调查结果。结论：LISTEN可显著改善糖尿病患者的健康相关生活质量，可能具有成本效益。点估计显示较低的平均成本与QALY的收益，但成本差异在统计上不显著。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Value in Health 医学-卫生保健

CiteScore

6.90

自引率

6.70%

发文量

3064

审稿时长

3-8 weeks

期刊介绍： Value in Health contains original research articles for pharmacoeconomics, health economics, and outcomes research (clinical, economic, and patient-reported outcomes/preference-based research), as well as conceptual and health policy articles that provide valuable information for health care decision-makers as well as the research community. As the official journal of ISPOR, Value in Health provides a forum for researchers, as well as health care decision-makers to translate outcomes research into health care decisions.