Systematic review on the cost and cost-effectiveness of mHealth interventions supporting women during pregnancy. Issue 1 (February 2023)

• Record Type: Journal Article
• Authors: Carrandi, Alayna; Hu, Yanan; Karger, Shae; Eddy, Katherine E.; Vogel, Joshua P.; Harrison, Cheryce L.; Callander, Emily
• Is Part Of: Women and birth. Volume 36:Issue 1(2023)
• Page Start: 3
• Page End: 10
• Publication Date: 2023-02
• Subjects: 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; Cost-effectiveness -- mHealth -- Pregnancy -- Apps -- Review; Midwives -- Periodicals; Pregnancy -- Periodicals; Midwifery -- Periodicals; Pregnancy -- Periodicals; 618.2
• DOI: 10.1016/j.wombi.2022.03.007
• Languages: English
• ISSNs: 1871-5192

Abstract

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.