RT Journal Article
SR Electronic
T1 Protocol for a quasi-experimental study of the effectiveness and cost-effectiveness of mother and baby units compared with general psychiatric inpatient wards and crisis resolution team services (The ESMI study) in the provision of care for women in the postpartum period
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e025906
DO 10.1136/bmjopen-2018-025906
VO 9
IS 3
A1 Kylee Trevillion
A1 Rebekah Shallcross
A1 Elizabeth Ryan
A1 Margaret Heslin
A1 Andrew Pickles
A1 Sarah Byford
A1 Ian Jones
A1 Sonia Johnson
A1 Susan Pawlby
A1 Nicky Stanley
A1 Diana Rose
A1 Gertrude Seneviratne
A1 Angelika Wieck
A1 Stacey Jennings
A1 Laura Potts
A1 Kathryn M Abel
A1 Louise M Howard
YR 2019
UL http://bmjopen.bmj.com/content/9/3/e025906.abstract
AB Introduction Research into what constitutes the best and most effective care for women with an acute severe postpartum mental disorder is lacking. The effectiveness and cost-effectiveness of psychiatric mother and baby units (MBUs) has not been investigated systematically and there has been no direct comparison of the outcomes of mothers and infants admitted to these units, compared with those accessing generic acute psychiatric wards or crisis resolution teams (CRTs). Our primary hypothesis is that women with an acute psychiatric disorder, in the first year after giving birth, admitted to MBUs are significantly less likely to be readmitted to acute care (an MBU, CRTs or generic acute ward) in the year following discharge than women admitted to generic acute wards or cared for by CRTs.Methods and analysis Quasi-experimental study of women accessing different types of acute psychiatric services in the first year after childbirth. Analysis of the primary outcome will be compared across the three service types, at 1-year postdischarge. Cost-effectiveness will be compared across the three service types, at 1-month and 1-year postdischarge; explored in terms of quality-adjusted life years. Secondary outcomes include unmet needs, service satisfaction, maternal adjustment, quality of mother–infant interaction. Outcomes will be analysed using propensity scoring to account for systematic differences between MBU and non-MBU participants. Analyses will take place separately within strata, defined by the propensity score, and estimates pooled to produce an average treatment effect with weights to account for cohort attrition.Ethics and dissemination The study has National Health Service (NHS) Ethics Approval and NHS Trust Research and Development approvals. The study has produced protocols on safeguarding maternal/child welfare. With input from our lived experience group, we have developed a dissemination strategy for academics/policy-makers/public.