Diabetes

DiabetesAssessing the cost-effectiveness of interventions for type-2 diabetes prevention

Sheffield contactChloe Thomas

What are the aims of this project?

The project aimed to develop a computer model that is able to evaluate a wide range of type-2 diabetes prevention interventions and work out which interventions are most effective and best value for money.

Why is this important?

Type-2 diabetes is becoming increasingly common in the UK. Diabetes reduces the quality of life of affected individuals, whilst costing society a huge amount in treatment of the disease and its complications. Many different diabetes prevention strategies have been developed, but to ensure that public money is used in the best way, it is necessary to provide decision makers with information about which policies are most cost-effective.

How will the research be carried out?

The model was developed in consultation with collaborators and stakeholders. Input from experts enabled the model to accurately represent the causes of diabetes, the care of patients and the outcomes of having the disease. A computer model was then built by health economic modellers. It allows a series of different type-2 diabetes prevention interventions to be evaluated in different high-risk population sub-groups, and can be flexibly adapted to the needs of policy-makers.

Timeframe

Model development started in 2012 and was completed in 2014. Follow-up projects are ongoing in 2015-16.

Who is undertaking the research?

The project is led by researchers at the University of Sheffield, with collaborators from UCL (University College London), the University of Exeter, the University of Cambridge and LiLac (Lancaster and Liverpool Universities Collaboration for Public Health Research).

How are stakeholders being engaged?

A varied group of stakeholders was involved in model development, including patients, clinicians and public health commissioners. They were invited to three workshops to help us explore our understanding of the problem, and to discuss the modelling approach and initial results.

What will be the outputs from the study?

Now that the model is complete, several follow-on projects are in progress to adapt it to evaluate different diabetes prevention programmes. In particular, a model adaptation has been used to support the NHS England business case for the proposed National Diabetes Prevention Programme (NDPP), and further work is underway with Public Health England to evaluate cost-effectiveness of the NDPP in different population sub-groups and in different local authorities. The model has also recently been used to evaluate a lifestyle intervention for individuals with learning disabilities, and to provide a local authority tool to Doncaster council to help them evaluate their weight management services.

A detailed methods report for the model is available on the web:

Breeze, P.R., Thomas, C., Squires, H., Brennan, A., Greaves, C., Diggle, P.J., Brunner, E., Tabak, A., Preston, L. and Chilcott, J.B., 2015. School for Public Health Research (SPHR) Diabetes Prevention Model: Detailed Description of Model Background, Methods, Assumptions and Parameters. http://www.sheffield.ac.uk/polopoly_fs/1.474948!/file/1501.pdf

Two academic publications have been published, with others to follow in the near future:

Breeze, P.R., Thomas, C., Squires, H., Brennan, A., Greaves, C., Diggle, P.J., Brunner, E., Tabak, A., Preston, L. and Chilcott, J., 2015. Impact of Type 2 diabetes prevention programmes based on risk identification and lifestyle intervention intensity strategies: a cost‐effectiveness analysis. Diabetic Medicine.  http://onlinelibrary.wiley.com/doi/10.1111/dme.12981/abstract

Breeze, P. Squires, H. Chilcott, J. Stride, C, Diggle, P.J. Brunner, E. Tabak, A. Brennan A. A statistical model to describe longitudinal and correlated metabolic risk factors to evaluate policies to prevent type 2 diabetes: the Whitehall II Prospective Study.  Journal of Public Health.   http://www.ncbi.nlm.nih.gov/pubmed/26547089

Conference contributions

Watson P. Squires H. Chilcott J. Stride C, Diggle P.J. Brunner E. Tabak A. Brennan A.  The development of a statistical model to describe longitudinal and correlated metabolic risk factors to evaluate policies to prevent type 2 diabetes. European Diabetes Epidemiology Group, Sardinia, 29th March -1st April 2014.

Breeze P, Brennan A, Chilcott J, Squires H, Diggle P, Brunner E, Tabak A, Greaves C. A policy analysis model to evaluate policies and interventions to prevent Type 2 diabetes. NIHR SPHR Annual Scientific Meeting, Sheffield, 22 October 2014. (poster)

Thomas C, Watson P, Greaves C, Squires H, Chilcott J, Brennan, A. Layering Interventions for Type-2 Diabetes Prevention using the SPHR Diabetes Model. ISPOR 17th Annual European Congress. 8-12 November 2014. Amsterdam RAI Amsterdam, The Netherlands.

Thomas, C, Watson, P, Greaves, C, Squires, H, Chilcott, J, Brennan, A. Validation of the SPHR Diabetes Prevention Model. ISPOR 17th Annual European Congress. 8-12 November 2014. Amsterdam RAI Amsterdam, Netherlands.

Breeze P, Thomas C., Squires H, Brennan A, Greaves C, Diggle P, Brunner E, Tabak A., Preston L, & Chilcott, J. Cost-effective allocation of resources for type-2 Diabetes prevention between high-risk subgroups. Personalised Medicine and Resource Allocation Conference, 2 March 2015, St Anne’s College, University of Oxford, Oxford.

The project findings were also disseminated via the Public Health Intelligence North East network on 18th November 2014 in York. This led to interest among public health practitioners and the subsequent follow on work.

Diabetes Case Study
Estimating the impact of diabetes prevention on public health: using modelling to aid translation of knowledge into action

 

Image by Victor under a Creative Commons License