{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T07:28:46Z","timestamp":1784014126811,"version":"3.55.0"},"reference-count":30,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006041","name":"Innovate UK","doi-asserted-by":"publisher","award":["104658"],"award-info":[{"award-number":["104658"]}],"id":[{"id":"10.13039\/501100006041","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>\n                      We aimed to assess a) whether using the digital intervention,\n                      <jats:italic>MyWay Diabetes<\/jats:italic>\n                      (MWD), during the COVID-19 pandemic in Greater Manchester was associated with improvements in glycaemia and cardiovascular risk factors; and b) the cost-effectiveness of MWD.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      From 01\n                      <jats:sup>st<\/jats:sup>\n                      July 2019\u201330\n                      <jats:sup>th<\/jats:sup>\n                      April 2022, we assessed risk factor changes in MWD users (n\u2009=\u2009507) with T2D, adjusting for changes in a matched control group of non-users (n\u2009=\u200910,135). Economic evaluation was conducted using United Kingdom Prospective Diabetes Study Outcomes Model version 2.1 simulating 1,000 patients over 40-years based on observed risk factor changes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Over 2-years follow-up, MWD use was associated with a clinically significant reductions in HbA1c of 3.1 (95%CI: 1.5 to 4.6) mmol\/mol and decreases in systolic blood pressure (1.4 (0.2 to 2.6) mmHg) and cholesterol (0.1 (0.02 to 0.2) mmol\/L) when compared to non-users. Including medication costs, MWD generated more health (0\u00b7015 QALYs) and lower costs (\u2212\u00a367 per person) compared to usual care. Excluding medication costs, MWD generated QALYs at a cost of \u00a3389 each, below the NICE threshold of \u00a320,000\u201330,000\/QALY.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>At population level, the risk factor changes associated with MWD are likely to reduce long-term diabetes-related complications risks and the intervention appears cost-effective.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0349232","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T17:24:10Z","timestamp":1782408250000},"page":"e0349232","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical and cost-effectiveness of the digital intervention, MyWay Diabetes, in people with type 2 diabetes living in Greater Manchester during the COVID-19 pandemic"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4875-4912","authenticated-orcid":true,"given":"Rathi","family":"Ravindrarajah","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Gittins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luke","family":"Paterson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Rogers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Tilson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah J.","family":"Wake","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doogie","family":"Brodie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott G.","family":"Cunningham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naresh","family":"Kanumilli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ewan","family":"Jones","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Elton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2290-4698","authenticated-orcid":true,"given":"Nicola","family":"Milne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5598-804X","authenticated-orcid":true,"given":"Michael","family":"Morgan-Curran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6450-5815","authenticated-orcid":true,"given":"Evangelos","family":"Kontopantelis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2972-7911","authenticated-orcid":true,"given":"Thomas","family":"Allen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin K.","family":"Rutter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,6,25]]},"reference":[{"key":"pone.0349232.ref001","volume-title":"National diabetes audit 2016-2017 full report \u2013 care processes and treatment targets England and Wales","author":"Digital N","year":"2018"},{"issue":"8","key":"pone.0349232.ref002","doi-asserted-by":"crossref","DOI":"10.2196\/26237","article-title":"Digital Interventions Supporting Self-care in People With Type 2 Diabetes Across Greater Manchester (Greater Manchester Diabetes My Way): Protocol for a Mixed Methods Evaluation","volume":"11","author":"J Goldthorpe","year":"2022","journal-title":"JMIR Res Protoc"},{"key":"pone.0349232.ref003","unstructured":"Greater Manchester Care Record. https:\/\/gmwearebettertogether.com\/ 2024."},{"key":"pone.0349232.ref004","unstructured":"NHS E. 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