Cost-utility analysis of provision of e-cigarette starter kits for smoking cessation in emergency departments: An economic evaluation of a randomized controlled trial.

Autor: Li J; Department of Health Sciences, University of York, York, UK., Wu Q; Department of Health Sciences, University of York, York, UK., Parrott S; Department of Health Sciences, University of York, York, UK., Pope I; Norfolk and Norwich University Hospital, Norwich, UK., Clark LV; Norwich Clinical Trials Unit, Norwich Medical School, University of East Anglia, Norwich, UK., Clark A; Norwich Clinical Trials Unit, Norwich Medical School, University of East Anglia, Norwich, UK., Ward E; Norwich Medical School, University of East Anglia, Norwich, UK., Belderson P; Norwich Medical School, University of East Anglia, Norwich, UK., Stirling S; Norwich Clinical Trials Unit, Norwich Medical School, University of East Anglia, Norwich, UK., Coats TJ; Department of Cardiovascular Sciences, University of Leicester, Leicester, UK., Bauld L; Usher Institute and SPECTRUM Consortium, College of Medicine, University of Edinburgh, UK., Holland R; Medical School, University of Leicester, Leicester, UK., Gentry S; Norwich Medical School, University of East Anglia, Norwich, UK., Agrawal S; University Hospitals of Leicester NHS Trust, Leicester, UK., Bloom BM; Royal London Hospital, Barts NHS Trust, London, UK., Boyle A; Addenbrookes Hospital, Cambridge University Hospitals Foundation Trust, Cambridge, UK., Gray A; Royal Infirmary Edinburgh, NHS Lothian, Edinburgh, UK., Morris MG; Homerton University Hospital NHS Trust, London, UK., Livingstone-Banks J; Nuffield Department of Primary Care Health Sciences, Oxford, UK., Notley C; Norwich Medical School, University of East Anglia, Norwich, UK.
Jazyk: angličtina
Zdroj: Addiction (Abingdon, England) [Addiction] 2024 Oct 31. Date of Electronic Publication: 2024 Oct 31.
DOI: 10.1111/add.16698
Abstrakt: Aims: To assess the cost-effectiveness of the Cessation of Smoking Trial in Emergency Department (COSTED) intervention compared with signposting to local stop smoking service (SSS) from the National Health Service (NHS) and personal social services (PSS) perspective.
Design, Setting and Participants: This was a two-group, multi-centre, pragmatic, individually randomized controlled trial set in six Emergency Departments (EDs) in urban and rural areas in the United Kingdom. Adult (≥ 18 years) daily smokers (at least one cigarette or equivalent per day) but not daily e-cigarette users, with carbon monoxide reading ≥ 8 parts per million, attending the ED (n = 972) were included. The intervention consisted of provision of an e-cigarette starter kit plus brief smoking cessation advice and referral to a local SSS. Control was an information card on how to access local SSS.
Measurements: Intervention costs included costs of training and delivery. Control costs included costs of printing information cards. Costs of smoking cessation and health-care services were estimated based on quantities reported by participants and unit costs extracted from secondary sources. The effects were measured by quality-adjusted life years (QALYs) derived from EQ-5D-5L. Other outcomes were smoking cessation measures. The primary outcome was incremental cost-effectiveness ratio (ICER), which was calculated by dividing the difference in costs by the difference in QALYs between groups.
Findings: The mean intervention costs were £48 [standard error (SE) = £0] per participant and the mean control costs were £0.2 (SE = £0) per participant. Using regression estimates, total costs were £31 [95% confidence interval (CI) = -£341 to £283] higher and 6-month QALYs were 0.004 (95% CI = -0.004 to 0.014) higher in the intervention group than in the control group. The ICER was calculated at £7750 (probability of cost-effective at range £20 000-30 000: 72.2-76.5%).
Conclusions: The UK Cessation of Smoking Trial in Emergency Department (COSTED) intervention (provision of an e-cigarette starter kit plus brief smoking cessation advice) was cost-effective compared with signposting to local stop smoking services under the current recommendations of the maximum acceptable thresholds.
(© 2024 The Author(s). Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.)
Databáze: MEDLINE
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