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针对非临床成年人群体的数字支持心理健康预防与促进的成本效益:系统评价

The Cost-Effectiveness of Digitally Supported Mental Well-Being Prevention and Promotion Targeting Nonclinical Adult Populations: Systematic Review.

作者信息

Claes Sara, Van De Wielle Fleur, Clays Els, Annemans Lieven

机构信息

Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, C Heymanslaan 10, Ghent, 9000, Belgium, +32 09 332 36 28.

出版信息

JMIR Ment Health. 2025 Aug 11;12:e72458. doi: 10.2196/72458.


DOI:10.2196/72458
PMID:40843487
Abstract

BACKGROUND: In recent years, policymakers worldwide have been increasingly concerned with promoting public mental well-being. While digitally supported well-being interventions seem effective in general nonclinical populations, their cost-effectiveness remains unclear. OBJECTIVE: This study aims to systematically synthesize evidence on the cost-effectiveness of digitally supported mental well-being interventions targeting the general population or adults with subclinical mental health symptoms. METHODS: PubMed, Embase, Scopus, and Web of Science were systematically searched for health economic or cost-minimization studies. Eligibility criteria included interventions in the general population or adults showing risk factors or subclinical mental health symptoms, with at least 1 digital component. Study quality was comprehensively assessed using the Consensus Health Economic Criteria list. RESULTS: Of 3455 records identified after duplicate removal, 12 studies were included: 3 studies evaluated universal prevention, 3 investigated selective prevention, and 6 covered indicated prevention. Six studies applied a societal perspective. Incremental cost-utility ratios were reported in 6 of the included studies and varied from dominant to €18,710 (US $ 23,185) per quality-adjusted life year. In general, digitally supported well-being interventions in nonclinical adults, and particularly indicated prevention strategies, seemed to generate improved health outcomes at lower costs from a societal perspective. The quality appraisal highlighted several shortcomings of the available literature. CONCLUSIONS: Overall, the use of digital tools for mental well-being prevention and promotion in nonclinical adult populations has the potential to be cost-effective. Nevertheless, to adequately guide policymaking, more evidence is still needed. Future studies should ensure valid argumentation for the applied time horizon and perspective, alongside rigorous sensitivity analyses in accordance with best practices to improve cost-effectiveness evidence. Furthermore, assessment methods more sensitive to changes in well-being such as the EQ Health and Well-being instrument could be considered.

摘要

背景:近年来,全球政策制定者越来越关注促进公众心理健康。虽然数字支持的心理健康干预措施在一般非临床人群中似乎有效,但其成本效益仍不明确。 目的:本研究旨在系统地综合针对普通人群或有亚临床心理健康症状的成年人的数字支持心理健康干预措施的成本效益证据。 方法:系统检索PubMed、Embase、Scopus和Web of Science上的卫生经济或成本最小化研究。纳入标准包括针对普通人群或有风险因素或亚临床心理健康症状的成年人的干预措施,且至少有一个数字组件。使用《卫生经济共识标准》清单全面评估研究质量。 结果:在去除重复记录后识别出的3455条记录中,纳入了12项研究:3项研究评估了普遍预防,3项研究了选择性预防,6项研究涵盖了针对性预防。6项研究采用了社会视角。纳入的6项研究报告了增量成本效用比,范围从占优到每质量调整生命年18,710欧元(23,185美元)。总体而言,从社会角度看,数字支持的非临床成年人心理健康干预措施,特别是针对性预防策略,似乎能以更低成本产生更好的健康结果。质量评估突出了现有文献的几个缺点。 结论:总体而言,在非临床成年人群中使用数字工具预防和促进心理健康有可能具有成本效益。然而,为了充分指导政策制定,仍需要更多证据。未来的研究应确保对应用的时间范围和视角进行有效论证,并按照最佳实践进行严格的敏感性分析,以改善成本效益证据。此外,可以考虑采用对幸福感变化更敏感的评估方法,如EQ健康与幸福感工具。

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本文引用的文献

[1]
A Universal Digital Stress Management Intervention for Employees: Randomized Controlled Trial with Health-Economic Evaluation.

J Med Internet Res. 2024-10-22

[2]
Economic evaluation of Be a Mom, a web-based intervention to prevent postpartum depression in high-risk women alongside a randomized controlled trial.

J Affect Disord. 2024-7-15

[3]
Mental Health and Well-Being in Racial or Ethnic Minority Individuals After Using a Faith and Prayer Mobile App (Pray.com): Feasibility and Preliminary Efficacy Trial.

JMIR Form Res. 2024-2-2

[4]
Cost of Implementing mHealth in Community Mental Health Settings: External Versus Internal Facilitation.

Psychiatr Serv. 2024-4-1

[5]
The Effectiveness of Fully Automated Digital Interventions in Promoting Mental Well-Being in the General Population: Systematic Review and Meta-Analysis.

JMIR Ment Health. 2023-10-19

[6]
Cost effectiveness review of text messaging, smartphone application, and website interventions targeting T2DM or hypertension.

NPJ Digit Med. 2023-8-18

[7]
The Effectiveness and Cost-Effectiveness of a Universal Digital Parenting Intervention Designed and Implemented During the COVID-19 Pandemic: Evidence From a Rapid-Implementation Randomized Controlled Trial Within a Cohort.

J Med Internet Res. 2023-7-27

[8]
The cost-effectiveness of a virtual intervention to prevent eating disorders in young women in Sweden.

Int J Eat Disord. 2023-10

[9]
Economic costs of implementing evidence-based telemedicine outreach for posttraumatic stress disorder in VA.

Implement Res Pract. 2022-8-2

[10]
Social return on investment of face-to-face versus online lifestyle coaching to improve mental wellbeing.

Lancet. 2022-11

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