Business case for psychosocial interventions in clinics: potential for decrease in treatment discontinuation and costs

Kaptein, Ad A., Harper, Joyce C., Dool, Grada van den, Schoonenberg, Marieke, Smeenk, Jesper, Daneshpour, Hirad, Troost, Meike, Wijk, Lise M. van, Tielen, Naomi, Smit, Ellen, Laven, Joop, Hoek, Annemieke and Boivin, Jacky ORCID: https://orcid.org/0000-0001-9498-1708 2024. Business case for psychosocial interventions in clinics: potential for decrease in treatment discontinuation and costs. Reproductive BioMedicine Online 49 (3) , 104113. 10.1016/j.rbmo.2024.104113 Item availability restricted.

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Abstract

Research question From a value-based healthcare (VBHC) perspective, does an assessment of clinical outcomes and intervention costs indicate that providing cognitive behavioural therapy (CBT) or mindfulness to women seeking fertility treatment have added value compared with no such intervention? Design Proof-of-concept business case based on a VBHC perspective that considers both clinical outcomes and costs. Potential impacts in psychological and fertility outcomes were based on existing literature. Cost outcomes were estimated with a costing model for the Dutch fertility treatment setting. Results 32 studies were identified; 13 could be included. Women who received CBT had 12% lower anxiety, 40% lower depression, and 6% higher fertility quality of life; difference in clinical pregnancy rates was 6-percentage points (CBT=30.2%; Control=24.2%); difference in fertility discontinuation rates was 10-percentage points (CBT=5.5%; Control=15.2%). Women who received training in mindfulness had 8% lower anxiety, 45% lower depression, and 21% higher fertility quality of life; difference in mean clinical pregnancy rate was 19-percentage points (Mindfulness=44.8%; Control=26.0%). Potential total cost savings for the was approximately €1.2 million per year if CBT was provided and €11 million if mindfulness was. Corresponding return-on-investment for CBT was 30.7% and for mindfulness 288%. Potential cost benefits are influenced by the assumed clinical pregnancy rates; such data related to mindfulness was limited to one study. Conclusions This proof-of-concept VBHC business case suggests providing CBT or mindfulness to women seeking fertility treatment could have added value. This conclusion would be bolstered by higher quality primary studies on the effect of mindfulness on clinical pregnancy rates.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Psychology
Additional Information:	License information from Publisher: LICENSE 1: Title: This article is under embargo with an end date yet to be finalised.
Publisher:	Elsevier
ISSN:	1472-6483
Date of First Compliant Deposit:	21 May 2024
Date of Acceptance:	10 May 2024
Last Modified:	08 Nov 2024 20:30
URI:	https://orca.cardiff.ac.uk/id/eprint/169057

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