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Is proactive telephone-based breastfeeding peer support a cost-effective intervention? A within-trial cost-effectiveness analysis of the ‘Ringing Up about Breastfeeding earlY’ (RUBY) randomised controlled trial

journal contribution
posted on 2023-06-16, 02:21 authored by Fiona E McLardie-Hore, Della A Forster, HL McLachlan, Touran Shafiei, Lisa H Amir, Mary-Ann Davey, Heather Grimes, Lisa GoldLisa Gold
ObjectiveThe ‘Ringing Up about Breastfeeding earlY’ (RUBY) randomised controlled trial showed increased breastfeeding at 6 months in participants who received the proactive telephone-based peer support breastfeeding intervention compared with participants allocated to receive standard care and supports. The present study aimed to evaluate if the intervention was cost-effective.DesignA within-trial cost-effectiveness analysis.SettingThree metropolitan maternity services in Melbourne, Victoria, Australia.ParticipantsFirst time mothers intending to breastfeed their infant (1152) and peer volunteers (246).InterventionThe intervention comprised proactive telephone-based support from a peer volunteer from early postpartum up to 6 months. Participants were allocated to usual care (n=578) or the intervention (n=574).Main outcome measuresCosts during a 6-month follow-up period including individual healthcare, breastfeeding support and intervention costs in all participants, and an incremental cost-effectiveness ratio.ResultsCosts per mother supported were valued at $263.75 (or $90.33 excluding costs of donated volunteer time). There was no difference between the two arms in costs for infant and mothers in healthcare and breastfeeding support costs. These figures result in an incremental cost-effectiveness ratio of $4146 ($1393 if volunteer time excluded) per additional mother breast feeding at 6 months.ConclusionConsidering the significant improvement in breastfeeding outcomes, this intervention is potentially cost-effective. These findings, along with the high value placed on the intervention by women and peer volunteers provides robust evidence to upscale the implementation of this intervention.Trial registration numberACTRN12612001024831.

History

Journal

BMJ Open

Volume

13

Article number

e067049

Pagination

1-13

Location

London, Eng.

ISSN

2044-6055

eISSN

2044-6055

Language

en

Publication classification

C1 Refereed article in a scholarly journal

Issue

6

Publisher

BMJ

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