Examining the cost effectiveness of interventions to promote the physical health of people with mental health problems: a systematic review

BMC Public Health

Reinhold Kilian¹  Thomas Becker¹  Carolin Von Gottberg⁴  Prisca Weiser⁴  David McDaid³  A-La Park² 

[1]Department of Psychiatry II, Ulm University, Bezirkskrankenhaus Günzburg, Germany

[2]Personal Social Services Research Unit, London School of Economics and Political Science, London, UK

[3]European Observatory on Health Systems and Policies, London School of Economics and Political Science, London, UK

[4]Department of Psychosomatic Medicine, Psychotherapy/Psychiatry, University of Mainz, Mainz, Germany

关键词: Public health;    Co-morbidities;    Economic evaluation;    Mental health;    Health promotion;   

Others  :  1161876
DOI  :  10.1186/1471-2458-13-787

 received in 2013-01-09, accepted in 2013-08-16,  发布年份 2013

【 摘 要 】

Background

Recently attention has begun to focus not only on assessing the effectiveness of interventions to tackle mental health problems, but also on measures to prevent physical co-morbidity. Individuals with mental health problems are at significantly increased risk of chronic physical health problems, such as cardiovascular disease or diabetes, as well as reduced life expectancy. The excess costs of co-morbid physical and mental health problems are substantial. Potentially, measures to reduce the risk of co-morbid physical health problems may represent excellent value for money.

Methods

To conduct a systematic review to determine what is known about economic evaluations of actions to promote better physical health in individuals identified as having a clinically diagnosed mental disorder, but no physical co-morbidity. Systematic searches of databases were supplemented by hand searches of relevant journals and websites.

Results

Of 1970 studies originally assessed, 11 met our inclusion criteria. In addition, five protocols for other studies were also identified. Studies looked at exercise programmes, nutritional advice, smoking, alcohol and drug cessation, and reducing the risk of blood borne infectious diseases such as HIV/AIDS and hepatitis. All of the lifestyle and smoking cessation studies focused on people with depression and anxiety disorders. Substance abuse and infectious disease prevention studies focused on people with psychoses and bipolar disorder.

Conclusions

There is a very small, albeit growing, literature on the cost effectiveness of interventions to promote the physical health of people with mental health problems. Most studies suggest that value for money actions in specific contexts and settings are available. Given that the success or failure of health promoting interventions can be very context specific, more studies are needed in more settings, focused on different population groups with different mental health problems and reporting intermediate and long term outcomes. There is a need to better distinguish between resource use and costs in a transparent manner, including impacts outside of the health care system. Issues such as programme fidelity, uptake and adherence should also be accounted for in economic analysis. The role of behavioural psychological techniques to influence health behaviours might also be considered.

【 授权许可】

   
2013 Park et al.; licensee BioMed Central Ltd.

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