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

Ad A Kaptein1, Joyce C Harper2, Grada van den Dool3

  • 1Department of Medical Psychology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands.

Reproductive Biomedicine Online
|July 23, 2024
PubMed
Summary
This summary is machine-generated.

Cognitive behavioural therapy (CBT) and mindfulness interventions may add value for women undergoing fertility treatment by improving psychological outcomes and increasing pregnancy rates. These therapies show potential for significant cost savings and return on investment in fertility care.

Keywords:
business casecognitive behavioural therapyfertility treatmentmindfulnesspsychosocial interventionsvalue-based health care

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Area of Science:

  • Reproductive Medicine
  • Mental Health
  • Health Economics

Background:

  • Value-based healthcare (VBHC) frameworks are increasingly important for assessing healthcare interventions.
  • Fertility treatments often involve significant psychological distress for patients.
  • The cost-effectiveness of adjunctive psychological therapies in fertility care requires thorough evaluation.

Purpose of the Study:

  • To assess the value of cognitive behavioural therapy (CBT) and mindfulness interventions for women undergoing fertility treatment from a VBHC perspective.
  • To compare clinical outcomes and intervention costs of CBT and mindfulness against no intervention.
  • To determine the potential return on investment for these psychological interventions in fertility care.

Main Methods:

  • A proof-of-concept business case was developed using a VBHC approach.
  • Clinical outcomes (anxiety, depression, quality of life, pregnancy rates) were synthesized from 13 included studies.
  • A costing model was used to estimate potential cost savings in the Dutch fertility treatment setting.

Main Results:

  • Cognitive behavioural therapy (CBT) was associated with reduced anxiety and depression, improved fertility quality of life, and higher clinical pregnancy rates (6 percentage points increase).
  • Mindfulness training showed greater improvements in psychological outcomes and a substantial increase in clinical pregnancy rates (19 percentage points).
  • Potential annual cost savings were estimated at €1.2 million for CBT and €11 million for mindfulness, with high returns on investment (30.7% for CBT, 288% for mindfulness).

Conclusions:

  • Cognitive behavioural therapy (CBT) and mindfulness interventions demonstrate potential value in improving outcomes and reducing costs for women seeking fertility treatment.
  • Mindfulness interventions, in particular, show a high potential return on investment, though further high-quality research on pregnancy rates is warranted.
  • Integrating psychological support through CBT or mindfulness could enhance the value proposition of fertility care.