1. Reference
144/2065
Smartphones and counselling for weight loss: Health and economic modelling
Authors:
Christine Cleghorn Nick Wilson, Nisha Nair, Giorgi Kvizhinadze, Nhung Nghiem, Melissa McLeod, Tony Blakely.
Workcenter:
Burden of Disease Epidemiology, Equity and Cost Effectiveness (BODE3) Programme, University of Otago, Wellington, New Zealand.
Background and Objectives: Dietary counselling by practice nurses and smartphone apps are two potentially cost effective weight loss interventions. We modelled the effect of these two interventions on health gain (in quality-adjusted life- years (QALYs)) and health system costs.
Methods: The modelled interventions were dietary counselling by dietician trained practice nurses and a smartphone app promotion intervention using currently available smartphone apps. A multi-state life-table model of the New Zealand (NZ) population (N=4.4 million in 2011), with 14 BMI-related disease life-tables, was used. The change in incidence in these disease life-tables flows through to impact on mortality and morbidity to change QALYs and associated health system costs.
Results: Dietary counselling resulted in a moderate, statistically non-significant, increase in QALYs and cost savings. The smartphone app intervention resulted in a small but statistically significant increase in QALYS and cost savings.
Table 1. Modelled health gains & net health system cost-savings in NZ adult population alive in 2011
Intervention
 Per
QALYs gained (95% uncertainty intervals [UI])
Net cost-savings in NZ$ million (95%UI)**
Dietary counselling
Total
1310 (-340 to 3180)
$21.4 (-6.2 to 52.5)
Per capita*
0.30
$4.85
Smartphone apps
156 (103 to 221)
$2.8 (1.8 to 4.1)
0.04
$0.62
*Per 1000 overweight/obese individuals **1.486 NZ$ =1US$ in base year 2011
The figure shows that if the NZ government was willing to pay NZ$45,000 per QALY gained (NZ GDP per capita per QALY), dietary counselling has an 69% likelihood of being cost effective and smartphone apps a 100% probability.
Conclusions: These two weight loss interventions were associated with relatively small health gains at a population level. Nevertheless, these are likely to be cost-saving interventions over the long-run and could therefore still form a small component of a wider obesity reduction strategy (especially if app quality and uptake increases in the future).
Keywords:
Weight loss; Cost-effectiveness modelling; Smartphone apps; Dietary counselling
Conflict of Interest:
None.
Acknowledgements:
This work was supported by funding from the Ministry of Business, Innovation and Employment (UOOX1406). Work on the underlying model was supported by a grant from the Health Research Council of NZ (10/248).
Full details in a forthcoming paper ( see BODE3 website: )