Cost-effectiveness of telehealth-delivered diet and exercise interventions: A systematic review

Lynette Law, Jaimon T. Kelly, Holly Savill, Matthew Wallen, Ingrid J. Hickman, Daniel Erku, Hannah Mayr

Research output: Contribution to journalReview articlepeer-review

Abstract

Objectives: Telehealth is a promising tool for delivering lifestyle interventions for the management of health conditions. However, limited evidence exists regarding the cost-effectiveness of these interventions. This systematic review aimed to
evaluate the current literature reporting on the cost-effectiveness of telehealth-delivered diet and/or exercise interventions.

Methods: Four electronic databases (PubMed, CENTRAL, CINAHL and Embase) were searched for published literature from database inception to November 2020. This review adhered to the preferred reporting items for systematic reviews
and meta-analyses guidelines and the ISPOR Criteria for Cost-Effectiveness Review Outcomes Checklist. The quality of reporting was assessed using the Consolidated Health Economic Evaluation Reporting Standards checklist. The extracted data were grouped into subcategories according to telehealth modality, organised into tables and reported narratively.

Results: Twenty-four studies of controlled trials (11 combined diet and exercise, 9 exercise-only and 4 diet-only tele-health-delivered interventions) were included for data extraction and quality assessment. Interventions were reported
as cost-effective in 12 studies (50%), five studies (21%) reported inconclusive results, and seven studies (29%) reported that the interventions were not cost-effective. Telephone interventions were applied in eight studies (33%), seven studies (29%) used internet interventions, six studies (25%) used a combination of internet and telephone interventions, and three studies (13%) evaluated mHealth interventions. Quality of study reporting varied with between 54% and 92% of
Consolidated Health Economic Evaluation Reporting Standards items reported.

Conclusions: This review suggests that telehealth-delivered lifestyle interventions can be cost-effective compared to traditional care. There is a need for further investigations that employ rigorous methodology and economic reporting,
including appropriate decision analytical models and longer timeframes.
Original languageEnglish
Number of pages18
JournalJournal of Telemedicine and Telecare
Early online date2 Feb 2022
DOIs
Publication statusE-pub ahead of print - 2 Feb 2022

Keywords

  • Telehealth
  • cost-effectiveness
  • cost-utility
  • lifestyle interventions
  • diet
  • exercise

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