A Health Literacy Intervention Targeting Chronic Kidney Disease Patients and Healthcare Professionals is Cost-saving: Findings from the Netherlands.

Abstract

Chronic kidney disease (CKD) is a progressive disease with high societal costs. CKD progression is influenced by patients' health literacy, i.e., the patients' ability to deal with information related to their own health. To assess the cost-effectiveness of Grip on Your Kidneys (GoYK), a multi-component health literacy intervention for CKD patients and their healthcare professionals. We performed a cost-utility analysis of the GoYK intervention, measuring health outcomes in terms of quality-adjusted life years (QALYs) and costs in euros, and extrapolated the results to a lifetime horizon using a Markov model. The GoYK study was a quasi-experimental study involving 147 patients with CKD and 48 healthcare professionals from Dutch general practices and nephrology clinics, followed over nine months. We found that the GoYK intervention would yield a cost-saving of €28,616 and a gain of 0.37 QALYs per CKD patient across the life course. Moreover, GoYK would avert 31 deaths and 113 new dialyses per 1,000 patients in the first 10 years. These results mainly stemmed from the intervention effect on the transition to end-stage renal disease, where reductions of as little as 1% would already mean GoYK is cost-saving. The intervention remained cost-effective in multiple sensitivity and scenario analyses. GoYK might be a solution to slow CKD progression and, thereby, reduce CKD costs. Given these promising findings and the novelty of our study, further research should confirm our findings before broad implementation.