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Health economic evaluations of preventative care for perinatal anxiety and associated disorders: a rapid review

Pisavadia, K., Spencer, L. H., Tuersley, L. , Coates, R. ORCID: 0000-0002-6944-6428, Ayers, S. ORCID: 0000-0002-6153-2460 & Edwards, R. T. (2024). Health economic evaluations of preventative care for perinatal anxiety and associated disorders: a rapid review. BMJ Open, 14(2), article number e068941. doi: 10.1136/bmjopen-2022-068941

Abstract

Objectives
Perinatal mental health problems affect one in five women and cost the UK £8.1 billion for every year of births, with 72% of this cost due to the long-term impact on the child. We conducted a rapid review of health economic evaluations of preventative care for perinatal anxiety and associated disorders.

Design
This study adopted a rapid review approach, using principles of the standard systematic review process to generate quality evidence. This methodology features a systematic database search, Preferred Reporting Items for Systematic Reviews and Meta-Analyses diagram, screening of evidence, data extraction, critical appraisal and narrative synthesis.

Data sources
PubMed, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Applied Social Sciences Index and Abstracts, PsycINFO and MEDLINE.

Eligibility criteria for selecting studies
Studies that evaluated the costs and cost-effectiveness of preventative care for perinatal anxiety and associated disorders carried out within the National Health Service and similar healthcare systems.

Data extraction and synthesis
A minimum of two independent reviewers used standardised methods to search, screen, critically appraise and synthesise included studies.

Results
The results indicate a lack of economic evaluation specifically for perinatal anxiety, with most studies focusing on postnatal depression (PND). Interventions to prevent postnatal mental health problems are cost-effective. Modelling studies have also been conducted, which suggest that treating PND with counselling would be cost-effective.

Conclusion
The costs of not intervening in maternal mental health outweigh the costs of preventative interventions. Preventative measures such as screening and counselling for maternal mental health are shown to be cost-effective interventions to improve outcomes for women and children.

Publication Type: Article
Additional Information: © Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
Publisher Keywords: Humans, Depression, Postpartum, Anxiety, Mental Health, Anxiety Disorders, Pregnancy, Child, Cost-Benefit Analysis, State Medicine, Female
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RG Gynecology and obstetrics
Departments: School of Health & Psychological Sciences
School of Health & Psychological Sciences > Midwifery & Radiography
SWORD Depositor:
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