Real-World Evaluation in the NHS
In 2015, the West of England AHSN launched an m-health challenge call in diabetes, developed jointly with Diabetes UK and the regional health and care community. The purpose of the pre-procurement call was to identify established products and services and implement pilots in the local region to support and promote self-management of type 1 and 2 diabetes. KiActiv® was one of five successful services responding to the call and was selected to be a partner on the regional Diabetes Digital Coach Challenge.
On the Diabetes Digital Coach Challenge, KiActiv® Health implemented a self-management programme with 179 type 1 and type 2 diabetes patients in Gloucestershire.
Over 97% of patients increased their physical activity, with 83.9% improving in 4 or more dimensions, with average improvements of:
- 1hr 29min reduction in sedentary time
- 44min increase in daily moderate activity
- 284kcal increase in calorie burn
- 2hr 36min increase in weekly moderate bouts
- 54min increase in weekly vigorous bouts
As a result of the programme, the group achieved physical activity levels that were shown to reduce HbA1c by 0.9%, which is associated with a risk reduction of 32.9% for microvascular complications.
Furthermore, as a result increased physical activity, patients reported experiencing a number of other quality of life benefits:
- weight loss
- reductions in pain
- reductions in medications
- improvements in mobility
- reductions in fatigue
- improved mood
Health economic evaluation of the programme demonstrated a positive return on investment within a one-year, five-year and 10-year time horizon. For every £1 spent, the model demonstrates a return on investment of £2.53, £15.63 and £43.40 at the respective time horizons. Economic benefit is achieved through the improvement in health outcomes, the reduction in future costs such as medicines, complications and co-morbidities, and productivity gains. The programme also demonstrated the opportunity to evaluate the wider impact on prescribing and healthcare usage for other conditions.