PROTECTOR pilot report: results, learnings, and recommendations

Western Cape Department of Health and Wellness, and Percept | February 2024

The PRO-Active TElemedicine TaCTical OpeRation (PROTECTOR) programme was a telehealth pilot intervention to support people living with poorly controlled diabetes. The aim of the intervention was to ascertain whether a short telehealth-delivered intervention could help patients to improve their diabetes control and self-efficacy and bring their measures (such as HbA1c) closer to clinically normal ranges.

The headline findings from the intervention were that of the 82 patients who completed the PROTECTOR pilot, the median change in HbA1c was 2.66 percentage points lower than their starting HbA1c level. This is a substantial result, given the relationship between lowering HbA1c levels and decreasing the risk of diabetes-related complications which are traumatic for patients and their providers, and costly to the health system.

Equally important is the feedback from patients, who found the intervention to be profoundly moving. The notion that one’s provider cares so much that they’re willing to call you when it’s convenient for you, was in many cases the push our participants needed to take action for their health. As one participant put it: “If you’re willing to help me”, he says, “then I’m willing to help myself.” Later, Mr K said, “If nobody is ever worried about you, or what you’re up to, then you also don’t worry.”

To determine the cost of scaling up PROTECTOR, the team developed an organogram and optimal patient load for a virtual clinic. If scaled up for the entire province (for patients with uncontrolled diabetes, HIV or Tuberculosis), the province would need to fund three virtual clinics at an additional cost of R16m. However, the return on investment was also calculated by determining the estimated savings due to averted health complications. Using two scenarios, one an average cost for all diabetes-related complications, and the other cost for only myocardial infarctions, we quantified the potential savings to the system. Even with a R16m outlay, the province would look to save between R63m and R139m, a return on investment of 284%-784% per year.

Read the comprehensive report of the PROTECTOR pilot below.

 

“Lifesaving Western Cape diabetes project offers massive savings – but funding has dried up”

Read our op-ed featured in Daily Maverick: