Virtual Caregiver Coach for You improved quality-adjusted life-years by 0.035 (95% CI 0.003-0.068) and was cost-effective with an ICER of $838 per QALY gained from a societal perspective.
RCT (n=250)
1:1
Does a virtual health coaching intervention improve quality-adjusted life-years and cost-effectiveness in informal caregivers of patients with heart failure?
A virtual health coaching intervention for informal caregivers of heart failure patients is cost-effective and improves quality-adjusted life-years.
Effect estimate: ICER $838 per QALY gained
Background Informal caregivers play an important role in heart failure care. Health coaching can effectively help informal caregivers adopt healthy lifestyles to prevent and control diseases. However, the cost‐effectiveness of interventions that support them remains unclear. We compare the cost‐effectiveness of a virtual health coaching intervention (Virtual Caregiver Coach for You) designed to support caregivers in managing their stress by promoting self‐care practices versus health information alone for informal caregivers of patients with heart failure. Methods In this randomized controlled trial, 250 informal caregivers were randomized (1: 1) to receive Virtual Caregiver Coach for You plus health information, or health information alone, for 6 months. The incremental cost‐effectiveness ratio was calculated as costs per quality‐adjusted life‐year gained over 12 months. A 2‐part model was used to estimate health care costs, and nonparametric bootstrapping with 1000 resamples was used to represent incremental cost‐effectiveness ratio uncertainty. Results Among the 165 caregivers in the primary analysis, the Virtual Caregiver Coach for You intervention improved quality‐adjusted life‐years by 0. 035 (95% CI, 0. 003–0. 068). From a health care sector perspective, the intervention was dominant: lower hospitalization rates (5% versus 8%) fully offset the program's costs, yielding average savings of 77. 45 (95% CI, 20. 74–134. 17) per caregiver. At a 50 000 per quality‐adjusted life‐year threshold, the intervention was cost‐effective in 99. 7% of simulated scenarios. From a societal perspective, the overall cost was 29. 71 per caregiver (95% CI, –37. 01 to 96. 44). The incremental cost‐effectiveness ratio was 838 per quality‐adjusted life‐year gained. Conclusions Virtual Caregiver Coach for You can be a cost‐effective intervention that improves the self‐care and quality of life of informal caregivers of patients with heart failure. REGISTRATION URL: https: //www. clinicaltrials. gov ; Unique identifier: NCT03988621.
Sun et al. (Sat,) conducted a rct in informal caregivers of patients with heart failure (n=250). Virtual Caregiver Coach for You vs. health information alone was evaluated on incremental cost-effectiveness ratio (costs per quality-adjusted life-year gained over 12 months) (ICER $838 per QALY gained). Virtual Caregiver Coach for You improved quality-adjusted life-years by 0.035 (95% CI 0.003-0.068) and was cost-effective with an ICER of $838 per QALY gained from a societal perspective.