Economic evaluations of psychological treatments for common mental disorders in low- and middle-income countries: protocol for a systematic review

Abstract

Background Common mental disorders (CMDs) are highly prevalent conditions that constitute a major public health and economic burden on society in low- and middle-income countries (LMICs). Despite the increased demand for economic evidence to support resource allocation for scaled-up implementation of mental health services in these contexts, economic evaluations of psychological treatments for CMDs remain scarce. Objective The proposed systematic review aims to synthesize findings on methods and outcomes of economic evaluations of psychological treatments for CMDs in LMICs and appraise quality. Methods We will identify, select, and extract data from published economic evaluations of psychological interventions for CMDs conducted in LMICs. We will search bibliographic databases (PubMed, EMBASE, CINAHL, Web of Science, EconLit, PsycINFO, Africa-Wide Information, Cochrane library, Centre for Reviews and Dissemination (CRD), Cost Effectiveness Analysis (CEA) Registry), and the African Journals Online (AJOL) and Google Scholar platforms. Only full economic evaluations (Cost-Effectiveness Analysis (CEA), Cost-Utility Analysis (CUA), Cost-Consequence Analysis (CCA), or Cost-Benefit Analysis (CBA)) of psychological treatments for CMDs (defined as depressive, anxiety, and substance use disorders) conducted in LMICs will be included. There will be no restrictions based on date of publication, perspective, follow-up duration or sample size. Data extraction will be guided by the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. Results The results presented will be examined using a narrative synthesis approach. The quality of included studies will be assessed using the Drummond & Jefferson checklist. Conclusion The fledgling evidence base in this area provides an opportunity to promote improved economic evaluation methods in line with repeated calls for economic evidence alongside effectiveness evidence in these settings. A rigorously developed economic evaluation evidence base will support resource allocation decisions for scaled up implementation of psychological interventions in LMIC settings. Systematic review registration PROSPERO CRD42020185277.

Gender and Context Matter: Behavioral and Structural Interventions for People Who Use Alcohol and Other Drugs in Africa

“…The Teachable Moments Programme was also implemented in South African emergency centers, having been developed as an extension of Sorsdahl et al, 2015 SBIRT [ 79 , 127 ]. However, more implementation data on cost-effectiveness analysis and economic evaluations are needed to demonstrate life cost savings and build an economic case for investment in these interventions [ 128 ]. Focus on both and PrEP among couples where AOD-impaired sex is a targeted behavior will be essential to ending the HIV epidemic.…”

Economic evaluation of psychological treatments for common mental disorders in low- and middle-income countries: a systematic review

“…The protocol for this review was registered with the international prospective register of systematic reviews PROS-PERO (PROSPERO, registration number CRD42020185 277). Methods used in the review have been previously published (Mutyambizi-Mafunda et al, 2021) and are only briefly presented here. Results are reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines (Page et al, 2021); see PRISMA checklist in Additional File 2.…”

“…The development of our search strategy is described in ( Mutyambizi-Mafunda et al ., 2021 ) and is included in Additional File 1. We conducted the literature search in March 2020, with updates in July 2020, March 2021 and a final update in December 2021.…”