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Systematic review on the cost and cost-effectiveness of mHealth interventions supporting women during pregnancy

      Abstract

      Objectives

      The increased integration of digital health into maternity care—alongside growing use of, and access to, personal digital technology among pregnant women—warrants an investigation of the cost-effectiveness of mHealth interventions used by women during pregnancy and the methodological quality of the cost-effectiveness studies.

      Methods

      A systematic search was conducted to identify peer-reviewed studies published in the last ten years (2011–2021) reporting on the costs or cost-effectiveness of mHealth interventions used by women during pregnancy. Available data related to program costs, total incremental costs and incremental cost-effectiveness ratios (ICERs) were reported in 2020 United States Dollars. The quality of cost-effectiveness studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS).

      Findings

      Nine articles reporting on eight studies met the inclusion criteria. Direct intervention costs ranged from $7.04 to $86 per woman, total program costs ranged from $241,341 to $331,136 and total incremental costs ranged from -$21.16 to $1.12 million per woman. The following ICERs were reported: $2168 per DALY averted, $203.44 per woman ceasing smoking, and $3475 per QALY gained. The full economic evaluation studies (n = 4) were moderate to high in quality and all reported the mHealth intervention as cost-effective. Other studies (n = 4) were low to moderate in quality and reported low costs or cost savings associated with the implementation of the mHealth intervention.

      Conclusions for practice

      Preliminary evidence suggests mHealth interventions may be cost-effective and “low-cost” but more evidence is needed to ascertain the cost-effectiveness of mHealth interventions regarding positive maternal and child health outcomes and longer-term health service utilisation.

      Abbreviations:

      ICER (Incremental Cost-Effectiveness Ratio), CHEERS (Consolidated Health Economic Evaluation Reporting Standards), DALY (Disability Adjusted Life Year), QALY (Quality Adjusted Life Year), SMS (Short Message Service), ICT (Information and Communication Technology), NHS (National Health Service), PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses), USD (United States Dollar), LMIC (Low-to-Middle-Income Country)

      Keywords

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