@article{TEXTUAL,
      recid = {9681},
      author = {Singla, Daisy R. and de Oliveira, Claire and Murphy, Sean  M. and Patel, Vikram and Charlebois, Jaime and Davis, Wendy  N. and Dennis, Cindy-Lee and Kim, J. Jo and Kurdyak, Paul  and Lawson, Andrea and Meltzer-Brody, Samantha and Mulsant,  Benoit H. and Schoueri-Mychasiw, Nour and Silver, Richard  K. and Tschritter, Dana and Vigod, Simone N. and Byford,  Sarah},
      title = {Protocol for an economic evaluation of scalable strategies  to improve mental health among perinatal women:  Non-specialist care delivered via telemedicine vs.  specialist care delivered in-person},
      journal = {BMC Psychiatry},
      address = {2023-11-08},
      number = {TEXTUAL},
      abstract = {&lt;p&gt;Background: Perinatal depression affects an estimated 1  in 5 women in North America during the perinatal period,  with annualized lifetime costs estimated at 20.6 billion  dollars CAD in Canada and over 45.9 billion dollars USD in  the US. Access to psychological treatments remains limited  for most perinatal women suffering from depression and  anxiety. Some barriers to effective care can be addressed  through task-sharing to non-specialist providers and  through telemedicine platforms. The cost-effectiveness of  these strategies compared to traditional specialist and  in-person models remains unknown. This protocol describes  an economic evaluation of non-specialist providers and  telemedicine, in comparison to specialist providers and  in-person sessions within the ongoing Scaling Up Maternal  Mental healthcare by Increasing access to Treatment  (SUMMIT) trial.&lt;/p&gt; &lt;p&gt;Methods: The economic evaluation  will be undertaken alongside the SUMMIT trial. SUMMIT is a  pragmatic, randomized, non-inferiority trial across five  North American study sites (N = 1,226) of the comparable  effectiveness of two types of providers (specialist vs.  non-specialist) and delivery modes (telemedicine vs.  in-person) of a behavioural activation treatment for  perinatal depressive and anxiety symptoms. The primary  economic evaluation will be a cost-utility analysis. The  outcome will be the incremental cost-effectiveness ratio,  which will be expressed as the additional cost required to  achieve an additional quality-adjusted life-year, as  assessed by the EuroQol 5-Dimension 5-Level instrument. A  secondary cost-effectiveness analysis will use  participants' depressive symptom scores. A micro-costing  analysis will be conducted to estimate the resources/costs  required to implement and sustain the interventions;  healthcare resource utilization will be captured via  self-report. Data will be pooled and analysed using uniform  price and utility weights to determine cost-utility across  all trial sites. Secondary country-specific cost-utility  and cost-effectiveness analyses will also be completed.  Sensitivity analyses will be conducted, and  cost-effectiveness acceptability-curves will be generated,  in all instances.&lt;/p&gt; &lt;p&gt;Discussion: Results of this study  are expected to inform key decisions related to  dissemination and scale up of evidence-based psychological  interventions in Canada, the US, and possibly worldwide.  There is potential impact on real-world practice by  informing decision makers of the long-term savings to the  larger healthcare setting in services to support perinatal  women with common mental health conditions.&lt;/p&gt;},
      url = {http://knowledge.uchicago.edu/record/9681},
}