Eight-year post-trial follow-up of health care and long-term care costs of tele-based health coaching

Erja Mustonen, Iiris Hörhammer, Pilvikki Absetz, Kristiina Patja, Johanna Lammintakanen, Martti Talja, Risto Kuronen, Miika Linna, Erja Mustonen, Iiris Hörhammer, Pilvikki Absetz, Kristiina Patja, Johanna Lammintakanen, Martti Talja, Risto Kuronen, Miika Linna

Abstract

Objective: To evaluate the long-term effect of telephone health coaching on health care and long-term care (LTC) costs in type 2 diabetes (T2D) and coronary artery disease (CAD) patients.

Data sources/study setting: Randomized controlled trial (RCT) data were linked to Finnish national health and social care registries and electronic health records (EHR). Post-trial eight-year economic evaluation was conducted.

Study design: A total of 1,535 patients (≥45 years) were randomized to the intervention (n = 1034) and control groups (n = 501). The intervention group received monthly telephone health coaching for 12 months. Usual health care and LTC were provided for both groups.

Principal findings: Intention-to-treat analysis showed no significant change in total health and long-term care costs (intervention effect €1248 [3 percent relative reduction], CI -6347 to 2217) in the intervention compared to the control group. There were also no significant changes among subgroups of patients with T2D or CAD.

Conclusions: Health coaching had a nonsignificant effect on health care and long-term care costs in the 8-year follow-up among patients with T2D or CAD. More research is needed to study, which patient groups, at which state of the disease trajectory of T2D and cardiovascular disease, would best benefit from health coaching.

Trial registration: ClinicalTrials.gov NCT00552903.

Keywords: coronary artery disease; costs; effectiveness; health coaching; type 2 diabetes.

Conflict of interest statement

None of the authors have any conflicts of interest to disclose.

© Health Research and Educational Trust.

Figures

Figure 1
Figure 1
The cumulative and annual health care and LTC (long‐term care) cost per patient over 8 years of follow‐up
Figure 2
Figure 2
Mean difference in 8‐year cumulative cost per patient and bootstrapped confidence intervals. Results among all participants and T2D and CAD subgroups [Color figure can be viewed at http://wileyonlinelibrary.com]
Figure 3
Figure 3
The incremental costs of tele‐based health coaching per patient grouped by service types

Source: PubMed

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