Effectiveness of mobile application for menstrual management of working women in Japan: randomized controlled trial and medical economic evaluation

Abstract

Aims: Hormonal imbalances can affect a woman’s physical and mental condition, impacting her daily life and productivity. A mobile application, “Karada-no-kimochi”, predicts the menstrual cycle based on recorded data, and provides the information regarding menstruation. This study investigates the effectiveness of the application from health condition and labor productivity loss perspectives, and evaluates its cost-effectiveness for employed women in Japan.

Materials and methods: A randomized controlled trial (RCT) was performed to compare the use of the application and non-intervention in female workers (20–45 years) based on an online survey. A discrete-event model based on the RCT data, published literature, and claims data was used for the cost-effectiveness analysis.

Results: The intervention and non-intervention groups comprised 612 and 914 women, respectively. In the intervention group, the incidences of depression (0.16%) and dysmenorrhea (0.33%) were significantly lower than those of the non-intervention group (0.77% and 1.31%, respectively) in the third month. While labor productivity and absenteeism varied, presenteeism showed almost no change across groups. The quality-adjusted life year in the intervention group was 6.84 (0.07 higher than that in the non-intervention group). By analyzing medical expenses and making assumptions regarding productivity, we estimated that the aggregate of medical expenses, productivity loss, and application fee for the intervention group could be lower than that of the non-intervention group by over JPY 130,000 (USD 1,170, as of December 2017) per individual.

Limitations: The subjects included were willing or relatively willing to use the application. Because all outcomes were based on online surveys, the results depended on the objectivity and preciseness of the reports provided by users, and those with severe symptoms might not provide reports.

Conclusions: The results suggest that using the application is cost-effective and might reduce the incidence of dysmenorrhea and depression.

KEYWORDS:

• Mobile application
• randomized controlled trial
• cost-effectiveness
• menstruation-associated symptoms
• self-health management
• menstrual cycle

JEL Classification Codes:

• I10
• I12
• O33

Acknowledgments

Kosuke Iwasaki, MBA, and Tomomi Takeshima, PhD, employees of Milliman Inc., provided data analysis, and writing and editorial support, respectively. We would also like to thank Editage (www.editage.jp) for English language editing.