Eren TİMURTAŞ, Kedar K. V. MATE, Gökçe KARTAL, İlkşan DEMİRBÜKEN, Yusuf ÇELİK, Mine Gülden POLAT, Mehveş TARIM

TİP 2 DİABETES MELLİTUS'TA MOBİL TEKNOLOJİ VE DENETİMLİ EGZERSİZ EĞİTİMİNİN MALİYET ANALİZİ

Amaç: Bu araştırmanın amacı, Tip-2 Diabetes Mellituslu (T2DM) kişilerin gözetimli egzersiz, akıllı telefon uygulaması ve akıllı saat kullanarak yaptıkları 12 haftalık egzersiz takibinin yapıldığı randomize kontrollü klinik çalışmanın maliyet analizinin yapılmasıdır. Yöntem: Denetimli egzersiz, akıllı telefon uygulaması ve akıllı saat yoluyla 12 hafta boyunca egzersiz uygulanan üç farklı T2DM grubu için Sosyal Sigortalar Kurumu tarafından yapılan ödemeler belirlenerek bütçe etkisi hesaplanmış ve maliyet etkinliği toplumsal bakış açısıyla hesaplanmıştır. Sonuç: Türk Lirası (TL) başına Kaliteye Ayarlanmış Yaşam Yıl (KAYY) değerleri denetimli egzersiz grubunda 14.863 TL; akıllı telefon uygulama grubunda 6056 TL, akıllı saat grubunda 7379 TL olarak bulundu. Maliyet etkinliği en yüksek olan yöntemin akıllı telefonla egzersiz uygulama yöntemi olduğu belirlendi. Maliyet analizinde KAYY değerlerindeki değişim denetimli egzersiz grubunda 0,11; akıllı telefon uygulama grubunda 0,12 ve akıllı saat grubunda 0,11 olarak hesaplandı. Tartışma: Maliyet etkinliği akıllı telefon uygulama grubunda yüksek, mobil uygulamalar grubunda orta ve denetimli egzersiz grubunda en düşük olup çalışmanın sonuçları literatür ile benzerlik göstermektedir.

Anahtar Kelimeler:

Maliyet Analizi, Diyabet, Egzersiz, Telerehabilitasyon

COST ANALYSIS OF MOBILE TECHNOLOGY AND SUPERVISED EXERCISE TRAINING IN TYPE 2 DIABETES MELLITUS

Keywords:

Cost-effectiveness, Diabetes, Exercise, Telerehabilitation,

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Collaboration NRF. Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4.4 million participants. Lancet. 2016;387(10027):1513-30.
Ogurtsova K, Da Rocha Fernandes JD, Huang Y, Linnenkamp U, Guariguata L, Cho NH, et. al. IDF Diabetes Atlas: global estimates for the prevalence of diabetes for 2015 and 2040. Diabetes Res Clin Pract. 2017;128:40-50.
González EM, Johansson S, Wallander MA, Rodríguez LG. Trends in the prevalence and incidence of diabetes in the UK: 1996–2005. J Epidemiol Community Health. 2009;63(4):332-336.
Seuring T, Archangelidi O, Suhrcke M. The economic costs of type 2 diabetes: a global systematic review. Pharmacoeconomics. 2015;33(8):811-831.
Nangır Ö, Yalçın Balçık P. Bir bakışta Avrupa ve Türkiye'de sağlık. STED/Sürekli Tıp Eğitimi Dergisi. 2016;25(2):78-86.
Marín-Peñalver JJ, Martín-Timón I, Sevillano-Collantes C, Del Cañizo-Gómez FJ. Update on the treatment of type 2 diabetes mellitus. World J Diabetes. 2016;7(17):354-395.
Colberg SR, Sigal RJ, Yardley JE, Riddell MC, Dunstan DW, Dempsey PC, et al. Physical activity/exercise and diabetes: a position statement of the American Diabetes Association. Diabetes Care. 2016;39(11):2065-79.
Vadstrup ES, Frølich A, Perrild H, Borg E, Røder M. Lifestyle intervention for type 2 diabetes patients–trial protocol of the Copenhagen type 2 diabetes rehabilitation project. BMC Public Health. 2009;9(1):166.
Yamaoka K, Tango T. Efficacy of lifestyle education to prevent type 2 diabetes: a meta-analysis of randomized controlled trials. Diabetes Care. 2005;28(11):2780-86.
Albalawi H, Coulter E, Ghouri N, Paul L. The effectiveness of structured exercise in the south Asian population with type 2 diabetes: a systematic review. Phys Sportsmed. 2017;45(4):408-417.
Boulé NG, Kenny GP, Haddad E, Wells GA, Sigal RJ. Meta-analysis of the effect of structured exercise training on cardiorespiratory fitness in type 2 diabetes mellitus. Diabetologia. 2003;46(8):1071-81.
Pippi R, Cugusi L, Bergamin M, Bini V, Fanelli CG, Bullo V et. al. Impact of BMI, physical activity, and sitting time levels on health-related outcomes in a group of overweight and obese adults with and without type 2 diabetes. J Funct Morphol Kinesiol. 2022;7(1):12.
Dennison L, Morrison L, Conway G, Yardley L. Opportunities and challenges for smartphone applications in supporting health behavior change: qualitative study. J Med Internet Res.2013;15(4):e86.
Connelly J, Kirk A, Masthoff J, MacRury S. The use of technology to promote physical activity in type 2 diabetes management: a systematic review. Diabet Med. 2013; 30(12):1420-32.
Liebreich T, Plotnikoff RC, Courneya KS, Boulé N. Diabetes NetPLAY: a physical activity website and linked email counselling randomized intervention for individuals with type 2 diabetes. Int J Behav Nutr Phys Act. 2009;6(1):1-15.
Najafi B, Farzadfar F, Ghaderi H, Hadian M. Cost-effectiveness of type 2 diabetes screening: a systematic review. Med J Islam Repub Iran. 2016;30:326.
Timurtaş E, Inceer M, Mayo N, Karabacak N, Sertbaş Y, Polat MG. Technology-based and supervised exercise interventions for individuals with type 2 diabetes: randomized controlled trial. Prim Care Diabetes. 2022;16(1):49-56.
Timurtaş E, Çınar E, Karabacak N, Sertbaş Y, Polat MG. A mobile application platform to increase physical activity in individuals with type 2 diabetes during the coronavirus (COVID-19) pandemic. Haydarpaşa Numune Med J. 2022;62(3):327-333.
Timurtaş E, Polat MG. Usability of mobile health application for individuals with type 2 diabetes mellitus and clinicians. Clin Exp Health Sci. 2020;10(1):54-59.
Kar A. Rüptüre olmamış serebral anevrizmaların tedavisinde cerrahi klipleme ve endovasküler koil yöntemlerinin maliyet etkililiğinin değerlendirilmesi. 2016. (Doctoral thesis, Hacettepe Üniversitesi).
Bakanlığı, T.C.S [Internet]. Sosyal güvenlik uygulamaları 2019 [updated 2021; cited 2019 Sep 26]; Kamu sağlık hizmetleri fiyat tarifesi. Available from: https://khgmfinansalanalizdb.saglik.gov.tr/TR-62098/2019-yili-fiyat-tarifeleri.html.
Višnjić A, Veličković V, Milosavljević NŠ. QALY-measure of cost-benefit analysis of health interventions. Acta Fac Med Naiss.2011;28(4):195-199.
Glick HA, Doshi JA, Sonnad SS, Polsky D. Economic evaluation in clinical trials. 2nd ed. OUP Oxford;2014.
Tripathy S, Hansda U, Seth N, Rath S, Rao PB, Mishra TS et al. Validation of the EuroQol Five-dimensions - three-level quality of life ınstrument in a classical Indian language (odia) and its use to assess quality of life and health status of cancer patients in eastern India. Indian J Palliat Care. 2015;21(3):282-8.
Rabin R, Charro FD. EQ-SD: a measure of health status from the EuroQol Group. Ann Med. 2001;33(5):337-43.
Burnham JM, Meta F, Lizzio V, Makhni EC, Bozic KJ. Technology assessment and cost-effectiveness in orthopaedics: how to measure outcomes and deliver value in a constantly changing healthcare environment. Curr Rev Musculoskelet Med. 2017;10(2):233-239.
Kirkness CS, Marcus RL, LaStayo PC, Asche CV, Fritz JM. Diabetes and associated risk factors in patients referred for physical therapy in a national primary care electronic medical record database. Phys Ther. 2008;88(11):1408–16.
Federation, I.D [Internet].Total cases of diabetes in adults 2019 [updated 2019; cited 2019 Aug 26]; Total cases of diabetes in adults.
TÜİK [Internet]. Sağlık harcamaları istatistikleri-2020. [updated 2021; cited 2022 Aug 12]. Available from: https://data.tuik.gov.tr/Bulten/Index?p=Saglik-harcamalari-Istatistikleri-2020.
Mounié M, Costa N, Gourdy P, Latorre C, Schirr-Bonnans S, Lagarrigue JM, et al. Cost-effectiveness evaluation of a remote monitoring programme ıncluding lifestyle education software in type 2 diabetes: results of the Educ@dom study. Diabetes Ther. 2022;13(4):693-708.
Brun JF, Bordenave S, Mercier J, Jaussent A, Picot MC, Préfaut C. Cost-sparing effect of twice-weekly targeted endurance training in type 2 diabetics: a one-year controlled randomized trial. Diabetes Metab. 2008;34(3):258-65.
Hwang R, Bruning J, Morris N, Mandrusiak A, Russell T. Cost-utility analysis of home-based tele–rehabilitation compared with centre-based programme in patients with heart failure. Heart Lung Circ. 2019;28(12):1795-1803.
Willems R, Tsoutsoulopoulou K, Brondeel R, Cardon G, Makrilakis K, Liatis S et. al. Cost-effectiveness analysis of a school-and community-based intervention to promote a healthy lifestyle and prevent type 2 diabetes in vulnerable families across Europe: the Feel4Diabetes-study. Prev Med. 2021;153:106722.
Economics DA. Value of accredited exercise physiologists in Australia. Australia: Exercise & Sports Science Australia; 2015.
Kühr EM, Ribeiro RA, Rohde LEP, Polanczyk CA. Cost-effectiveness of supervised exercise therapy in heart failure patients. Value Health. 2011;14(5):100-107.
He Q, Zhao X, Wang Y, Xie Q, Cheng L. Effectiveness of smartphone application–based self‐management interventions in patients with type 2 diabetes: a systematic review and meta‐analysis of randomized controlled trials. J Adv Nurs. 2022;78(2):348-362.
Friel KM, Gillespie P, Coates V, McCauley C, McCann M, O’Kane M, et. al. Estimating and examining the costs of inpatient diabetes care in an Irish public hospital. Diabet Med. 2022;39(4):e14753.