Systematic review on the cost and cost-effectiveness of mHealth interventions supporting women during pregnancy |
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| Institution: | 1. Women’s Health Economics, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC 3004, Australia;2. Maternal, Child and Adolescent Health Program, Burnet Institute, 85 Commercial Road, Melbourne, VIC 3004, Australia;3. Cochrane Australia, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC 3004, Australia;4. Monash Centre for Health Research and Implementation, Level 1, 43–51 Kanooka Grove, Clayton, VIC 3168, Australia;1. School of Public Health, University of Adelaide, Adelaide, South Australia 5005, Australia;2. Discipline of General Practice, University of Adelaide, Adelaide, South Australia 5005, Australia;3. Robinson Research Institute, University of Adelaide, Adelaide, South Australia 5005, Australia;4. Department of Obstetrics and Gynaecology, Lyell McEwin Hospital, Adelaide, South Australia 5005, Australia;5. Adelaide Medical School, Faculty of Health & Medical Sciences, University of Adelaide, Adelaide, SA 5005, Australia;6. Population Health Sciences, University of Bristol, Bristol, UK;7. School of Health and Society, University of Wollongong, Wollongong, NSW 2500, Australia;1. School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, 2751 NSW, Australia;2. Education Queensland, QLD 4564, Australia;3. MAK Consulting, Bruce, ACT 2617, Australia;4. Canberra Mothercraft Society, PO Box 126, Curtin, 2605 ACT, Australia;5. School of Nursing and Midwifery, Griffith University, 68 University Drive, Meadowbrook, QLD 4131, Australia;6. Transforming Maternity Care Collaborative, Australia;7. School of Law, University of Sydney, Camperdown, NSW 2006, Australia;8. Human Rights in Childbirth;9. BWLaw, Australia;1. Artesis Plantijn University College, Noorderplaats 2, 2000 Antwerp, Belgium;2. Edinburgh Napier University, School of Health and Social Care, Sighthill Court, Edinburgh EH11 4BN, Scotland, United Kingdom;3. School of Community Health & Midwifery, University of Central Lancashire, Preston, United Kingdom;4. University of Barcelona, Faculty of Medicine and Health Sciences, Bellvitge Health Sciences Campus, Carrer de la Feixa Llarga, s/n. 08907 L′Hospitalet de Llobregat, Barcelona, Spain;5. University of Barcelona, Faculty of Law, Avinguda Diagonal, 684, 08028 Barcelona, Spain;6. Charles University, Faculty of Social Sciences, U Krize 8, 158 00 Prague, Czech Republic;7. Universitätsklinik Graz, Auenbruggerplatz 14, 8036 Graz, Austria;8. Institute for Midwifery, Charite Universitätsmedizin Berlin, Berlin, Germany;1. Level 3 Chamberlain Building, School of Nursing Midwifery and Social Work, University of Queensland, St Lucia, Queensland, Australia;2. Faculty of Health, Engineering and Sciences, University of Southern Queensland, 11 Salisbury Rd, Ipswich, Queensland 4305, Australia;3. Molly Wardaguga Research Centre, College of Nursing & Midwifery, Charles Darwin University, Level 11, East building, 410 Ann St, Brisbane, Queensland 4000, Australia;4. Molly Wardaguga Research Centre, College of Nursing & Midwifery, Charles Darwin University, 17 Grevillea Drive, Sadadeen, Alice Springs 0870, Australia;1. School of Nursing, Midwifery and Public Health, University of Canberra, Australia;2. School of Nursing and Midwifery, University of Newcastle, Australia;3. School of Nursing and Public Health, University of Canberra and ACT Government Health Directorate, Australia |
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| Abstract: | ObjectivesThe 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.MethodsA 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).FindingsNine 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 practicePreliminary 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. |
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| Keywords: | Cost-effectiveness mHealth Pregnancy Apps Review |
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