OBJECTIVES: This paper identifies, collates, and summarises empirical evidence on the economic impact of interventions to improve continence, mobility, and psychological wellbeing in individuals with neuro-physical disabilities (NPD) within a community-based setting.

METHODS: A systematic literature review was conducted across six databases (MEDLINE, CINAHL, PubMed, University of York’s CDR, PsycINFO, Cochrane Library) as recommended by national guidelines, using a PICOS framework. The review protocol was registered in PROSPERO (CRD42023414752). The search strategy used search strings comprised of three groups of search terms: population condition, intervention characteristics and economic filters. The review focused on community-based studies examining minimally to non-invasive interventions, as well as clinical-based studies focusing on interventions which could be performed at the community level. Studies in the form of full or partial economic evaluations and health technology assessments, published since January 1990 were considered for inclusion. Methodological quality of included studies was assessed using the CHEC-List.

RESULTS: 1,033 studies were identified and 14 studies met the inclusion criteria: 4 for continence, 5 for mobility and 5 for psychological wellbeing. The majority of studies focus on progressive or acquired NPDs. Included studies represent 5 countries: United Kingdom, United States, Germany, Japan and Australia. The review includes 8 full economic evaluations and 6 partial economic evaluations; the latter being defined as reporting some cost elements. The following interventions are included: abdominal massage and transanal irrigation for continence; several at-home programmes and physiotherapy for mobility; cognitive behavioural therapy in various forms, telephone counselling and adjustment group therapy for psychological wellbeing.

CONCLUSIONS: Evidence on the economic impact of community-based interventions to improve continence, mobility, and psychological wellbeing in individuals with NPDs, particularly congenital NPDs, is sparse. Minimally invasive continence interventions are more likely to be cost-effective compared to non-invasive intervention, but findings regarding mobility and psychological wellbeing interventions were considerably mixed.