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Abstract
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.
Highlights
Common mental disorders (CMDs) are highly prevalent conditions that con stitute a major public health and economic burden on society in low- and middle-income countries (LMICs)
The review will aim to answer the following research questions: what are the methods used in these economic evaluations; what is the qual ity of these economic evaluations; are valid conclu sions drawn from these economic evaluations; do they support or limit decision making; and how can economic evaluation methods be improved to sup port resource allocation decisions for psychological treatments for CMDs? To answer these questions, the primary objectives of the review are to:
The most comprehensive focused on the cost-effectiveness and affordability of a wide range of treatment and prevention interventions for Mental Neurological and Substance Use (MNS) in LMICs and was conducted as part of the Disease Control Priorities (DCP) program by Levin and Chisholm (2016) [30]
Summary
Common mental disorders (CMDs) are highly prevalent conditions that con stitute 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, eco nomic evaluations of psychological treatments for CMDs remain scarce. Recent global health estimates show that these disorders accounted for 63% to 69% [10] of disability attributable to mental and substance use dis orders across low- and middle-income countries (LMICs). The large global economic burden of mental illness is disproportionately carried by LMIC populations [11], the economic evalua tion evidence needed to inform resource allocation [6,15,16] remains limited in these settings
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