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

Reproductive biomedicine online
September 1, 2024
Ad A Kaptein et al. (13 authors)
Journal ArticleHuman Study
Study Details

Study Goal

The researchers aimed to determine whether providing CBT or mindfulness to women seeking fertility treatment adds value from a VBHC perspective by assessing clinical outcomes and intervention costs.

Results Summary

CBT reduced anxiety by 12%, depression by 40%, and improved fertility quality of life by 6%, with a 6-percentage-point increase in clinical pregnancy rates. Mindfulness reduced anxiety by 8%, depression by 45%, and improved fertility quality of life by 21%, with a 19-percentage-point increase in clinical pregnancy rates. Potential cost savings were €1.2 million for CBT and €11 million for mindfulness annually.

Population

Women seeking fertility treatment.

Effective Dosage

Not specified

Duration

Not specified

Interactions

None mentioned

Extracted Claims (13)
InterventionDirectionEndpointPopulationDosageImpactClaim #
cognitive behavioural therapy (CBT)
decrease
anxiety
women seeking fertility treatment
12%
had 12% lower
#1
cognitive behavioural therapy (CBT)
decrease
depression
women seeking fertility treatment
40%
had 40% lower
#2
cognitive behavioural therapy (CBT)
increase
fertility quality of life
women seeking fertility treatment
6%
had 6% higher
#3
cognitive behavioural therapy (CBT)
increase
clinical pregnancy rates
women seeking fertility treatment
six percentage points
difference in clinical pregnancy rates was six percentage points
#4
cognitive behavioural therapy (CBT)
decrease
fertility discontinuation rates
women seeking fertility treatment
10 percentage points
difference in fertility discontinuation rates was 10 percentage points
#5
mindfulness
decrease
anxiety
women seeking fertility treatment
8%
had 8% lower
#6
mindfulness
decrease
depression
women seeking fertility treatment
45%
had 45% lower
#7
mindfulness
increase
fertility quality of life
women seeking fertility treatment
21%
had 21% higher
#8
mindfulness
increase
clinical pregnancy rate
women seeking fertility treatment
19 percentage points
difference in mean clinical pregnancy rate was 19 percentage points
#9
cognitive behavioural therapy (CBT)
increase
total cost savings
women seeking fertility treatment
€1.2 million per year
Potential total cost savings was about €1.2 million per year
#10
mindfulness
increase
total cost savings
women seeking fertility treatment
€11 million
Potential total cost savings was about €11 million
#11
cognitive behavioural therapy (CBT)
increase
return on investment
women seeking fertility treatment
30.7%
Corresponding return on investment for CBT was 30.7%
#12
mindfulness
increase
return on investment
women seeking fertility treatment
288%
Corresponding return on investment for mindfulness was 288%
#13
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 add value compared with no such intervention? DESIGN: Proof-of-concept business case based on a VBHC perspective that considers clinical outcomes and costs. Potential effects on psychological and fertility outcomes were based on existing research. Cost outcomes were estimated with a costing model for the Dutch fertility treatment setting. RESULTS: Thirty-two studies were identified; 13 were 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 six 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 was about €1.2 million per year if CBT was provided and €11 million if mindfulness was provided. 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 were limited to one study. CONCLUSIONS: The provision of CBT or mindfulness to women seeking fertility treatment could add value. Higher quality primary studies are needed on the effect of mindfulness on clinical pregnancy rates.

Medical Subject Headings (MeSH)
HumansFemalePregnancyCognitive Behavioral TherapyMindfulnessQuality of LifePsychosocial InterventionDepressionPregnancy RateAdultAnxietyCost-Benefit Analysis
Study Links
Quality Scores
SafetyNot Assessed
Efficacy85/10
Quality75/10
Citation Metrics
Total Citations1
Citations/Year1.0
Research Impact Scores
APT Score0.25
Weight Score2.50
Normalized Score0.69
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