The Value of Nonpharmacological Interventions for People With an Acquired Brain Injury: A Systematic Review of Economic Evaluations

Eileen Mitchell, Elayne Ahern, Sanjib Saha, Grainne McGettrick, Dominic Trepel

Research output: Contribution to journalReview articlepeer-review


Objectives: Acquired brain injury (ABI) has long-lasting effects, and patients and their families require continued care and
support, often for the rest of their lives. For many individuals living with an ABI disorder, nonpharmacological
rehabilitation treatment care has become increasingly important care component and relevant for informed healthcare
decision making. Our study aimed to appraise economic evidence on the cost-effectiveness of nonpharmacological
interventions for individuals living with an ABI.
Methods: This systematic review was registered in PROSPERO (CRD42020187469), and a protocol article was subject to peer
review. Searches were conducted across several databases for articles published from inception to 2021. Study quality was
assessed according the Consolidated Health Economic Evaluation Reporting Standards checklist and Population, Intervention,
Control, and Outcomes criteria.
Results: Of the 3772 articles reviewed 41 publications met the inclusion criteria. There was a considerable heterogeneity
in methodological approaches, target populations, study time frames, and perspectives and comparators used. Keeping
these issues in mind, we find that 4 multidisciplinary interventions studies concluded that fast-track specialized services
were cheaper and more cost-effective than usual care, with cost savings ranging from £253 to £6063. In 3
neuropsychological studies, findings suggested that meditated therapy was more effective and saved money than
usual care. In 4 early supported discharge studies, interventions were dominant over usual care, with cost savings
ranging from £142 to £1760.
Conclusions: The cost-effectiveness evidence of different nonpharmacological rehabilitation treatments is scant. More robust
evidence is needed to determine the value of these and other interventions across the ABI care pathway.
Original languageEnglish
Number of pages13
JournalValue in Health
Publication statusE-pub ahead of print - 2022 May 5

Subject classification (UKÄ)

  • Health Care Service and Management, Health Policy and Services and Health Economy


  • acquired brain injury
  • economic evaluation
  • nonpharmacological interventions
  • stroke
  • systematic review


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