Evidence map›Paper›PMID 38421806›Full record

Trial reportDiabetic medicine : a journal of the British Diabetic Association2024

Cost-effectiveness of a Novel Hypoglycaemia Programme: The 'HARPdoc vs BGAT' RCT.

Andrew Healey, Tayana Soukup, Nick Sevdalis, Ioannis Bakolis, Samantha Cross, Simon R Heller, Augustin Brooks, Dulmini Kariyawasam, Elena Toschi, Linda Gonder-Frederick and 7 more

Open access · hybridAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Diabetic medicine : a journal of the British Diabetic Association, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact, top 97% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 0 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors at 8 institutions in 2 countries.

Andrew HealeyCentre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.ORCID https://orcid.org/0000-0003-2013-3161
Tayana SoukupCentre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.ORCID https://orcid.org/0000-0003-0203-7264
Nick SevdalisCentre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.ORCID https://orcid.org/0000-0001-7560-8924
Ioannis BakolisCentre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.ORCID https://orcid.org/0000-0002-4800-1630
Samantha CrossCentre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.ORCID https://orcid.org/0000-0002-0501-0289
Simon R HellerDepartment of Oncology and Metabolism, University of Sheffield, Sheffield, UK.ORCID https://orcid.org/0000-0002-2425-9565
Augustin BrooksUniversity Hospitals Dorset NHS Foundation Trust, Bournemouth, UK.ORCID https://orcid.org/0000-0002-8486-4441
Dulmini KariyawasamDepartment of Diabetes and Endocrinology, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Elena ToschiJoslin Diabetes Center, Harvard Medical School, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0003-4077-1160
Linda Gonder-FrederickDepartment of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, USA.ORCID https://orcid.org/0000-0002-3009-2626
Marietta StadlerDepartment of Diabetes, School of Cardiovascular and Metabolic Medicine & Sciences, King's College, London, UK.ORCID https://orcid.org/0000-0001-6869-9960
Helen RogersDepartment of Diabetes, King's College Hospital NHS Foundation Trust, London, UK.ORCID https://orcid.org/0000-0003-4557-0691
Kimberley GoldsmithDepartment of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Pratik ChoudharyDepartment of Diabetes, School of Cardiovascular and Metabolic Medicine & Sciences, King's College, London, UK.ORCID https://orcid.org/0000-0001-7635-4735
Nicole de ZoysaDepartment of Diabetes, King's College Hospital NHS Foundation Trust, London, UK.ORCID https://orcid.org/0000-0003-0895-2666
Stephanie A AmielDepartment of Diabetes, School of Cardiovascular and Metabolic Medicine & Sciences, King's College, London, UK.ORCID https://orcid.org/0000-0003-2686-5531
HARPdoc RCT Study Group
King's College London · GBKing's College Hospital NHS Foundation Trust · GBDorset HealthCare University NHS Foundation Trust · GBGuy's and St Thomas' NHS Foundation Trust · GBJoslin Diabetes Center · USUniversity of Leicester · GBUniversity of Sheffield · GBUniversity of Virginia · US

Funding

SPECIAL ASSAY COREP30DK036836 · NIDDK · JOSLIN DIABETES CENTER · PI ROHIT N. KULKARNI · 1986 to 2026
$50.5M
Breakthrough T1D 4-SRA-2017-255-M-NNIDDK NIH HHS P30 DK036836
6 · The paper itself

Abstract

aimsTo assess the cost-effectiveness of HARPdoc (Hypoglycaemia Awareness Restoration Programme for adults with type 1 diabetes and problematic hypoglycaemia despite optimised care), focussed upon cognitions and motivation, versus BGAT (Blood Glucose Awareness Training), focussed on behaviours and education, as adjunctive treatments for treatment-resistant problematic hypoglycaemia in type 1 diabetes, in a randomised controlled trial.

methodsEligible adults were randomised to either intervention. Quality of life (QoL, measured using EQ-5D-5L); cost of utilisation of health services (using the adult services utilization schedule, AD-SUS) and of programme implementation and curriculum delivery were measured. A cost-utility analysis was undertaken using quality-adjusted life years (QALYs) as a measure of trial participant outcome and cost-effectiveness was evaluated with reference to the incremental net benefit (INB) of HARPdoc compared to BGAT.

resultsOver 24 months mean total cost per participant was £194 lower for HARPdoc compared to BGAT (95% CI: -£2498 to £1942). HARPdoc was associated with a mean incremental gain of 0.067 QALYs/participant over 24 months post-randomisation: an equivalent gain of 24 days in full health. The mean INB of HARPdoc compared to BGAT over 24 months was positive: £1521/participant, indicating comparative cost-effectiveness, with an 85% probability of correctly inferring an INB > 0.

conclusionsAddressing health cognitions in people with treatment-resistant hypoglycaemia achieved cost-effectiveness compared to an alternative approach through improved QoL and reduced need for medical services, including hospital admissions. Compared to BGAT, HARPdoc offers a cost-effective adjunct to educational and technological solutions for problematic hypoglycaemia.

Indexed as

Cost-Benefit AnalysisDiabetes Mellitus, Type 1HypoglycemiaQuality-Adjusted Life YearsQuality of LifeAdultBlood GlucoseFemaleHumansHypoglycemic AgentsMaleMiddle AgedPatient Education as TopicBlood GlucoseHypoglycemic Agentscost‐effectivenesshealth economicshypoglycaemiaquality of liferandomised controlled trialservice utilizationtype 1 diabetes

Identifiers

PMID38421806
PMCPMC12728598
OpenAlexW4392297572

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.