Effectiveness and cost-effectiveness of community-based mental health services for individuals with severe mental illness in Iran: a systematic review and meta-analysis
Effectiveness and cost-effectiveness of community-based mental health services for individuals with severe mental illness in Iran: a systematic review and meta-analysis
Blog Article
Abstract Background Severe mental illness (SMI) imposes a substantial worldwide burden of disability, highlighting the need for comprehensive and adaptable mental health services.This study aims to assess the efficacy and cost-effectiveness of community-based mental health services (CBMHS) in reducing relapse and rehospitalization rates among individuals with SMI in Iran.Method A systematic review and meta-analysis were conducted.Medline, EMBASE, ISI, SCOPUS, and ProQuest were searched until December 2022.
We focused on randomized controlled trials, quasi-experimental studies, or economic studies related to individuals with SMI.Out of 127 articles, 17 were selected for a full-text review.The primary outcomes were travc the severity of psychopathology, rehospitalization rates, and the mental health of caregivers.We also examined community-based interventions and their impact on various outcomes.
Data extraction and risk of bias assessment were performed, and critical appraisal was conducted using JBI checklists.Meta-analysis was carried out using STATA software.(PROSPERO registration.CRD42022332660).
Result Rehospitalization rates among patients who received CBMHS were significantly lower, with an odds ratio of 2.14 (95% CI: 1.44 to 3.19), indicating a 2.
14 times lower likelihood than those who received treatment as usual.A reduction in psychopathology accompanied this, SMD: -0.31, 95% CI: -0.49 to -0.
13, I2 = 40.23%).Moreover, there was a notable improvement in social skills (SMD: -0.7, 95% CI: -0.
98 to -0.44, I2 = 0.00%).The burden on caregivers also decreased (SMD: -0.
55, 95% CI: -0.99 to -0.1, I2 = 63.2).
The Incremental Cost-Effectiveness Ratio (ICER) for QUALY was acceptable, albeit with a wide range of 613 to 8400 Dollars.Conclusion CBMHS has demonstrated effectiveness and efficiency in Iran as a developing country.Additionally, it shows promise in mitigating the shortage of acute psychiatry beds.Using frondescence boise multiple data collection tools poses a limitation regarding data consolidation and conducting a meta-analysis.