Authors' objectives: HTW undertook an evidence review to address the following question: what is the clinical and cost effectiveness of remotely monitoring blood glucose compared to usual (clinic-based) care in women with gestational diabetes?

Authors' results and conclusions: HTW identified three randomised controlled studies that reported the effectiveness of using remote blood glucose monitoring in gestational diabetes. Two studies used mobile phone app-based systems only one of which is currently available in the UK (GDm-Health) and the third used a telemedicine hub that was installed in the pregnant woman’s home. The timing and frequency of blood glucose monitoring varied in each study and two of the studies were over three years old and due to the type of technology used, may therefore be of limited relevance in current practice. The studies did not report any difference in the majority of clinical outcomes between women using remote blood glucose monitoring and those using standard care, although some evidence suggested that women using remote blood glucose monitoring may be less likely to require a caesarean section. None of the studies reported on the reduction in clinic attendance as an outcome: two studies were not designed to include the outcome and one was not able to report on the outcome due to booking errors (both arms continued to attend the same number of clinics). One of the studies included economic evidence and reported a lower mean cost for each delivery for the GDm-Health app. However, this difference was not statistically significant. HTW produced a resource impact analysis showed that the overall impact of the GDm-Health app was highly dependent on the assumptions around downstream cost savings. This uncertainty makes it difficult to know whether the introduction of GDm-Health would lead to a net cost increase or cost savings.

Authors' methods: The Evidence Appraisal Report is based on a literature search (strategy available on request) for published clinical and economic evidence on the health technology of interest. It is not a full systematic review but aims to identify the best available evidence on the health technology of interest. Researchers critically evaluate and synthesise this evidence. We include the following clinical evidence in order of priority: systematic reviews; randomised trials; non-randomised trials. We only include evidence for “lower priority” evidence where outcomes are not reported by a “higher priority” source. We also search for economic evaluations or original research that can form the basis of an assessment of costs/cost comparison. We carry out various levels of economic evaluation, according to the evidence that is available to inform this.

Project Status: Completed

Year Published: 2020

URL for published report: https://www.healthtechnology.wales/reports-guidance/remote-blood-glucose-monitoring/

English language abstract: An English language summary is available

Publication Type: Rapid Review

Country: Wales, United Kingdom

Organisation Name: Health Technology Wales

Contact Address: c/o Digital Health Care Wales, 21 Cowbridge Road East Cardiff CF11 9AD

Contact Name: Susan Myles, PhD

Contact Email: healthtechnology@wales.nhs.uk

Copyright: Health Technology Wales