One-Year Outcomes and a Cost-Effectiveness Analysis for Smokers Accessing Group-Based and Pharmacy-Led Cessation Services
One-Year Outcomes and a Cost-Effectiveness Analysis for Smokers Accessing Group-Based and Pharmacy-Led Cessation Services
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DOI：
10.1093/ntr/ntq222
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发表时间：
2011-02-01
影响因子：
4.7
通讯作者：
Hiscock, Rosemary
中科院分区：
文献类型：
--
作者：
Bauld, Linda;Boyd, Kathleen A.;Hiscock, Rosemary
一项观察性研究检查了格拉斯哥两个国家卫生服务戒烟服务的客户的1年随访，用于告知成本效益分析。一项服务涉及7周的基于小组的支持（n = 411），另一项服务包括长达12周的药剂师一对一咨询（n = 1，374）。戒烟的药理学辅助（例如，计算戒烟日期后52周每种服务的戒烟率，并将其用于与基线“自我戒烟”方案相比，对基于药房和团体的干预措施的年度和终身成本效益进行经济评估。年成本效益模型建立了每52周戒烟者的增量成本，而马尔可夫模型被开发用于寿命分析，以估计潜在的寿命结果，即获得的每质量调整生命年（QALY）的成本，考虑到戒烟者从戒烟中获得的延长寿命和改善生活质量的好处。一氧化碳-两种服务的有效戒烟者从4周随访的22.5%下降到52周的3.6%。团体服务的戒烟率（6.3%）高于药房服务（2.8%），但更密集，需要更大的管理费用。终身分析的结果是，小组支持的每QALY增量成本为4，800磅，药房一对一咨询的增量成本为2，600磅。尽管1年的戒烟率令人失望，但这两种服务都被认为是非常划算的。
An observational study examining 1-year follow-up of clients of two National Health Service smoking cessation services in Glasgow was used to inform a cost-effectiveness analysis. One service involved 7 weeks of group-based support (n = 411) and the other consisted of up to 12 weeks of one-to-one counseling with pharmacists (n = 1,374). Pharmacological aids to quitting (e.g., nicotine replacement therapy) were available to all clients.Quit rates were calculated for each service at 52 weeks after the quit date, and these were used for an economic evaluation of both the annual and the lifetime cost-effectiveness of the pharmacy- and group-based interventions in comparison with a baseline "self-quit" scenario. The annual cost-effectiveness model established the incremental cost per 52-week quitter, while a Markov model was developed for the lifetime analysis to estimate the potential lifetime outcomes in terms of cost per quality-adjusted life years (QALY) gained, to account for the benefits quitters will receive in terms of extended life years and improvements in quality of life from smoking cessation.The proportion of carbon monoxide-validated quitters from both services combined fell from 22.5% at 4-week follow-up to 3.6% at 52 weeks. The group service achieved a higher quit rate (6.3%) than the pharmacy service (2.8%) but was more intensive and required greater overhead costs. The lifetime analysis resulted in an incremental cost per QALY of 4,800 pound for the group support and 2,600 pound for pharmacy one-to-one counseling.Despite disappointing 1-year quit rates, both services were considered to be highly cost-effective.