The cost-effectiveness of providing a DAFNE follow-up intervention to predicted non-responders 2012

The Dose Adjustment for Normal Eating (DAFNE) course is a structured education programme for adults with Type 1 diabetes. DAFNE has been found to improve glycosylated haemoglobin (HbA1c) levels in UK Type 1 diabetes patients1 and a cost-effectiveness modelling analysis concluded that DAFNE was cost-effective2. This analysis assumed that HbA1c benefit experienced by patients receiving DAFNE was homogeneous, however it has been found that HbA1c response to DAFNE is highly variable between patients. Although some patients do experience significant HbA1c reductions after DAFNE, other patients experience a worsening of HbA1c1,3 and some find it difficult to maintain initial HbA1c improvements4. Offering an early ‘follow-up’ intervention to those patients predicted from their initial change in psychosocial characteristics not to respond to DAFNE in the long term may be cost-effective if additional HbA1c benefit can be gained.

This study aims to explore statistical modelling methodologies to predict individual clinical responses to DAFNE from psychosocial characteristics and incorporate psychosocial predictors into an economic simulation model to investigate the cost-effectiveness of providing a follow-up intervention to subgroups of predicted non-responders.