Cost-effectiveness of interventions for perinatal anxiety and/or depression: a systematic review.
Cost-effectiveness of interventions for perinatal anxiety and/or depression: a systematic review.
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DOI：
10.1136/bmjopen-2018-022022
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发表时间：
2018-08-10
期刊：
影响因子：
2.9
通讯作者：
Shields GE
中科院分区：
文献类型：
--
作者：
Camacho EM;Shields GE
怀孕期间或产后一年的焦虑和/或抑郁是分娩最常见的并发症。对预防或治疗围产期焦虑和/或抑郁(PAD)的干预措施进行了系统的经济评价，目的是指导围产期心理健康服务的研究人员和专员采取可能具有成本效益的战略。2017年9月，在MEDLINE、emocINFO和NHS经济评价和卫生技术评估数据库上进行了电子搜索，以确定自2000年1月以来发表的相关经济评价。采用预先规定的纳入/排除标准进行两个阶段的筛选。在文献检索前设计了数据提取表，以获取关键数据。已公布的清单被用来评估确定的出版物的质量。在确定的168项无重复引用中，有8项研究符合审查的纳入标准；除了一项研究外，所有研究都只关注母亲的产后抑郁症。干预措施包括预防(3/8)、治疗(3/8)或识别+治疗(2/8)。有两种干预措施可能具有成本效益，都包括识别和治疗。在报告每获得质量调整的生命年(QALY)的成本的情况下，干预措施的范围从占主导地位(比通常的护理更便宜和更有效)到成本GB 39875/QALY。不同研究在设置和设计方面的不确定性和异质性使得很难进行直接比较或得出强有力的结论。然而，这两种包括识别和治疗围产期抑郁症的干预措施都可能是具有成本效益的。在经济证据中发现了许多差距，例如对围产期焦虑、产前抑郁或对父亲的干预的成本效益。CRD42016051133。
Anxiety and/or depression during pregnancy or year after childbirth is the most common complication of childbearing. Economic evaluations of interventions for the prevention or treatment of perinatal anxiety and/or depression (PAD) were systematically reviewed with the aim of guiding researchers and commissioners of perinatal mental health services towards potentially cost-effective strategies. Electronic searches were conducted on the MEDLINE, PsycINFO and NHS Economic Evaluation and Health Technology Assessment databases in September 2017 to identify relevant economic evaluations published since January 2000. Two stages of screening were used with prespecified inclusion/exclusion criteria. A data extraction form was designed prior to the literature search to capture key data. A published checklist was used to assess the quality of publications identified. Of the 168 non-duplicate citations identified, 8 studies met the inclusion criteria for the review; all but one focussing solely on postnatal depression in mothers. Interventions included prevention (3/8), treatment (3/8) or identification plus treatment (2/8). Two interventions were likely to be cost-effective, both incorporated identification plus treatment. Where the cost per quality-adjusted life year (QALY) gained was reported, interventions ranged from being dominant (cheaper and more effective than usual care) to costing £39 875/QALY. Uncertainty and heterogeneity across studies in terms of setting and design make it difficult to make direct comparisons or draw strong conclusions. However, the two interventions incorporating identification plus treatment of perinatal depression were both likely to be cost-effective. Many gaps were identified in the economic evidence, such as the cost-effectiveness of interventions for perinatal anxiety, antenatal depression or interventions for fathers. CRD42016051133.
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