TY - JOUR
T1 - Economic Cost of the HealthCall Smartphone Intervention to Reduce Heavy Alcohol Drinking in Adults With HIV
AU - Starbird, Laura E.
AU - Gutkind, Sarah
AU - Teixeira, Paul
AU - Murphy, Sean
AU - Aharonovich, Efrat
AU - Zingman, Barry S.
AU - Hasin, Deborah
AU - Schackman, Bruce R.
N1 - Publisher Copyright:
© 2023, Alcohol Research Documentation Inc.. All rights reserved.
PY - 2023/11
Y1 - 2023/11
N2 - Objective: Alcohol use among people living with HIV (PLWH) can reduce adherence and worsen health outcomes. We evalu-ated the economic cost of an effective smartphone application (Health-Call) to reduce drinking and improve antiretroviral adherence among heavy-drinking PLWH participating in a randomized trial. Method: Participants were randomized to receive a brief drinking-reduction intervention, either (a) the National Institute on Alcohol Abuse and Alcoholism (NIAAA) Clinician’s Guide (CG-only, n = 37), (b) CG enhanced by HealthCall to monitor daily alcohol consumption (CG+HealthCall, n = 38), or (c) motivational interviewing delivered by a nonclinician enhanced by HealthCall (MI+HealthCall, n = 39). We used micro-costing techniques to evaluate start-up costs and incremental costs per participant incurred from the health care sector perspective in 2018 U.S. dollars. We also investigated potential cost offsets using participant-reported health care utilization. Results: Participants attended three intervention visits, and each visit cost on average $29 for CG-only, $32 for CG+HealthCall, and $15 for MI+HealthCall. The total intervention cost per participant was $94 for CG-only, $114 for CG+HealthCall, and $57 for MI+HealthCall; the incremental cost of CG+HealthCall compared with CG-only was $20 per participant, and the incremental savings of MI+HealthCall compared with CG-only was $37 per participant. No significant differences in health care utilization occurred among the three groups over 12 months. Conclusions: The cost of enhancing CG with the HealthCall application for heavy-drinking PLWH was modestly higher than using the CG alone, whereas MI enhanced with HealthCall delivered by a nonclinician had a lower cost than CG alone. HealthCall may be a low-cost enhancement to brief interventions addressing alcohol use and antiretroviral adherence among PLWH.
AB - Objective: Alcohol use among people living with HIV (PLWH) can reduce adherence and worsen health outcomes. We evalu-ated the economic cost of an effective smartphone application (Health-Call) to reduce drinking and improve antiretroviral adherence among heavy-drinking PLWH participating in a randomized trial. Method: Participants were randomized to receive a brief drinking-reduction intervention, either (a) the National Institute on Alcohol Abuse and Alcoholism (NIAAA) Clinician’s Guide (CG-only, n = 37), (b) CG enhanced by HealthCall to monitor daily alcohol consumption (CG+HealthCall, n = 38), or (c) motivational interviewing delivered by a nonclinician enhanced by HealthCall (MI+HealthCall, n = 39). We used micro-costing techniques to evaluate start-up costs and incremental costs per participant incurred from the health care sector perspective in 2018 U.S. dollars. We also investigated potential cost offsets using participant-reported health care utilization. Results: Participants attended three intervention visits, and each visit cost on average $29 for CG-only, $32 for CG+HealthCall, and $15 for MI+HealthCall. The total intervention cost per participant was $94 for CG-only, $114 for CG+HealthCall, and $57 for MI+HealthCall; the incremental cost of CG+HealthCall compared with CG-only was $20 per participant, and the incremental savings of MI+HealthCall compared with CG-only was $37 per participant. No significant differences in health care utilization occurred among the three groups over 12 months. Conclusions: The cost of enhancing CG with the HealthCall application for heavy-drinking PLWH was modestly higher than using the CG alone, whereas MI enhanced with HealthCall delivered by a nonclinician had a lower cost than CG alone. HealthCall may be a low-cost enhancement to brief interventions addressing alcohol use and antiretroviral adherence among PLWH.
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U2 - 10.15288/jsad.22-00377
DO - 10.15288/jsad.22-00377
M3 - Article
C2 - 37449954
AN - SCOPUS:85176496482
SN - 1937-1888
VL - 84
SP - 814
EP - 822
JO - Journal of Studies on Alcohol and Drugs
JF - Journal of Studies on Alcohol and Drugs
IS - 6
ER -