Dataset Information

Economic evaluation of a brief counselling for smoking cessation in dentistry: a case study comparing two health economic models.

ABSTRACT:

Objectives

This study aimed to compare the cost-effectiveness estimates of a brief counselling of smoking cessation in dentistry by using two different health economic models.

Design and outcome measures

Intervention effectiveness was estimated in a cluster randomised controlled trial. The number of quitters was estimated based on 7-day abstinence and on smoking reduction at follow-up. Health economic evaluation was performed using two models: (1) a population-based model employing potential impact fractions and (2) a Markov model estimating the cost-effectiveness of the intervention for the actual participants. The evaluation was performed from healthcare and societal perspectives, and health gains were expressed in quality-adjusted life-years (QALYs).

Setting

Dental clinics in Sweden.

Participants

205 Swedish smokers aged 20-75 years.

Interventions

A brief, structured behavioural intervention was compared with 'usual care'.

Results

The cost per quitter was US$552 in the intervention and US$522 in the 'usual care' condition. The net saving estimated with the population-based model was US$17.3?million for intervention and US$49.9?million for 'usual care', with health gains of 1428 QALYs and 2369 QALYs, respectively, for the whole Swedish population during 10 years. The intervention was thus dominated by 'usual care'. The reverse was true when using the Markov model, showing net societal savings of US$71?000 for the intervention and US$57000 for 'usual care', with gains of 5.42 QALYs and 4.74 QALYs, respectively, for lifelong quitters.

Conclusion

The comparison of intervention and 'usual care' derived from small-scale studies may be highly sensitive to the choice of the model used to calculate cost-effectiveness.

Trial registration

The cluster randomised trial is registered in the ISRCTN register of controlled trials with identification number ISRCTN50627997.

SUBMITTER: Virtanen SE

PROVIDER: S-EPMC5541608 | biostudies-literature | 2017 Jul

REPOSITORIES: biostudies-literature

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Publications

Economic evaluation of a brief counselling for smoking cessation in dentistry: a case study comparing two health economic models.

Virtanen Suvi Erika SE Galanti Maria R MR Johansson Pia M PM Feldman Inna I

BMJ open 20170720 7

<h4>Objectives</h4>This study aimed to compare the cost-effectiveness estimates of a brief counselling of smoking cessation in dentistry by using two different health economic models.<h4>Design and outcome measures</h4>Intervention effectiveness was estimated in a cluster randomised controlled trial. The number of quitters was estimated based on 7-day abstinence and on smoking reduction at follow-up. Health economic evaluation was performed using two models: (1) a population-based model employin ...[more]

PMID: 28729321

Similar Datasets

Project description:BackgroundThe Dutch Healthcare Inspectorate supervises care providers in order to improve quality of care. Recently the inspectorate assessed and promoted the use of a guideline on smoking-cessation counselling in midwifery practices. The supervision programme consisted of an announcement of the enforcement deadline for the guideline and site visits. The purpose of our qualitative study was to identify factors related to guideline adherence after the supervision programme, and investigate whether the programme had helped improve adherence.MethodsWe conducted semi-structured interviews with inspected and non-inspected midwives. Additionally, we studied documents and observed the inspection process. The sampled midwives all work in primary care midwifery practices providing care to pregnant smokers. The questions included the current provision of smoking-cessation counselling, support to the midwife in counselling, recent changes in provision of counselling, reasons for recent changes, knowledge about the supervision programme, and experiences with supervision by the inspectorate.ResultsOur results show that guideline adherence depends on several factors. Awareness and familiarity with the guideline are important, as is outcome expectancy. Additionally, motivation, guideline factors and environment factors were mentioned. Besides these previously documented factors, we found that professional collaboration also determined guideline adherence. Increased collaboration in counselling is associated with greater adherence to the guideline, such as provision of counselling and taking required training. The supervision programme helped improve stop-smoking counselling, by making midwives aware of the counselling and giving them an extrinsic motivation to provide counselling.ConclusionMotivation and environmental aspects were the most important factors related to guideline adherence, and professional environment was added as significant factor. The improved guideline adherence is partly attributable to the supervision programme.

Dataset Information

Economic evaluation of a brief counselling for smoking cessation in dentistry: a case study comparing two health economic models.

Objectives

Design and outcome measures

Setting

Participants

Interventions

Results

Conclusion

Trial registration

Publications

Economic evaluation of a brief counselling for smoking cessation in dentistry: a case study comparing two health economic models.

Similar Datasets

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