Economic Cost of the HealthCall Smartphone Intervention to Reduce Heavy Alcohol Drinking in Adults with HIV.
Academic Article
Overview
abstract
OBJECTIVE: Alcohol use among people living with HIV (PLWH) can reduce adherence and worsen health outcomes. We evaluated the economic cost of an effective smartphone application (HealthCall) 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 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 non-clinician 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 healthcare sector perspective in 2018 USD. We also investigated potential cost offsets using participant-reported healthcare utilization. RESULTS: Participants attended 3 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 to CG-only was $20 per participant and the incremental savings of MI+HealthCall compared to CG-only was $37 per participant. No significant differences in healthcare 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 non-clinician 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.
