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Cost-utility of a web-based intervention to promote maternal mental health among postpartum women presenting low risk for postpartum depression

Published online by Cambridge University Press:  21 July 2022

Fabiana Monteiro Open the ORCID record for Fabiana Monteiro [Opens in a new window] ,
Patrícia Antunes ,
Marco Pereira ,
Maria C. Canavarro  and
Ana Fonseca
Fabiana Monteiro*
Affiliation:
University of Coimbra, Center for Research in Neuropsychologu and Cognitive Behavioral Intervention, Faculty of Psychoogy and Educational Sciences, Coimbra, Portugal
Patrícia Antunes
Affiliation:
Centre for Health Studies and Research, Faculty of Economics, University of Coimbra, Coimbra, Portugal
Marco Pereira
Affiliation:
University of Coimbra, Center for Research in Neuropsychologu and Cognitive Behavioral Intervention, Faculty of Psychoogy and Educational Sciences, Coimbra, Portugal
Maria C. Canavarro
Affiliation:
University of Coimbra, Center for Research in Neuropsychologu and Cognitive Behavioral Intervention, Faculty of Psychoogy and Educational Sciences, Coimbra, Portugal
Ana Fonseca
Affiliation:
University of Coimbra, Center for Research in Neuropsychologu and Cognitive Behavioral Intervention, Faculty of Psychoogy and Educational Sciences, Coimbra, Portugal
*
* Author for correspondence: Fabiana Monteiro, E-mail: fgmonteiro.91@gmail.com
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Abstract

Objectives

Web-based interventions for the promotion of maternal mental health could represent a cost-effective strategy to reduce the burden associated with perinatal mental illness. This study aimed to evaluate the cost-utility of Be a Mom, a self-guided web-based cognitive behavioral therapy intervention, compared with a waiting-list control.

Methods

The economic evaluation alongside a randomized controlled trial was conducted from a societal perspective over a 14-month time frame. Postpartum women presenting low risk for postpartum depression were randomized to the intervention (n = 191) or control (n = 176) group and assessed at baseline, postintervention and 4 and 12 months after postintervention. Data regarding healthcare use, productive losses and quality-adjusted life years (QALYs) were collected and used to calculate incremental cost-effectiveness ratios (ICERs). Uncertainty was accounted for with nonparametric bootstrapping and sensitivity analyses.

Results

At 14 months, and after accounting for a 3.5 percent discount rate, the intervention resulted in a yearly cost-saving of EUR 165.47 (−361.77, 28.51) and a QALY gain of 0.0064 (−0.0116, 0.0244). Bootstrapping results revealed a dominant ICER for the intervention group. Although results were statistically nonsignificant, cost-effectiveness acceptability curves showed that at a EUR 0 willingness to pay threshold, there is a 96 percent probability that the intervention is cost-effective when compared with the control group. The sensitivity analyses generally supported the acceptable likelihood of the intervention being more cost-effective than the control group.

Conclusions

From a societal perspective, the implementation of Be a Mom among low-risk postpartum women could be a cost-effective way to improve perinatal mental health.

Keywords

Cost-utilityWeb-based interventionPostpartum periodQuality-adjusted life yearsRandomized controlled trial
Type
Assessment
Information
International Journal of Technology Assessment in Health Care , Volume 38 , Issue 1 , 2022 , e62
Copyright
© The Author(s), 2022. Published by Cambridge University Press

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