An economic evaluation of a computer-tailored e-learning program to promote smoking cessation counseling guideline adherence among practice nurses (Preprint)

2018 ◽  
Author(s):  
Dennis de Ruijter ◽  
Ciska Hoving ◽  
Silvia Evers ◽  
Raesita Hudales ◽  
Hein de Vries ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Guideline Adherence ◽  
Cost Utility ◽  
Learning Program ◽  
Smoking Cessation Counseling ◽  
Practice Nurses ◽  
Patient Level ◽  
E Learning

BACKGROUND To date, no evidence is available about the cost-effectiveness of digital support programs to improve smoking cessation care by healthcare professionals in primary care. OBJECTIVE To conduct an economic evaluation of a tailored e-learning program, which successfully improved practice nurses’ smoking cessation guideline adherence, from a societal perspective. METHODS The economic evaluation was embedded in a randomized controlled trial, in which 269 practice nurses recruited 388 smoking patients. Cost-effectiveness was assessed using guideline adherence as effect measure on practice nurse level, and continued smoking abstinence on patient level. Cost-utility was assessed on patient level, using patients’ Quality Adjusted Life Years (QALYs) as effect measure. RESULTS The e-learning program was likely to be cost-effective on practice nurse level, as adherence to an additional guideline step cost €1,586. On patient level, cost-effectiveness was slightly likely after six months (cost per additional quitter: €7,126), but not after twelve months. The cost-utility analysis revealed slight cost-effectiveness (cost per QALY gained: €18,431) on patient level. CONCLUSIONS Providing practice nurses with a tailored e-learning program is cost-effective to improve their smoking cessation counseling. Cost-effectiveness on patient level was not found, which may result from smoking relapse. Widespread implementation of the e-learning program can improve the quality of smoking cessation care in general practice. Strategies to prevent patients’ smoking relapse should be further explored to improve patients’ long-term abstinence. CLINICALTRIAL Dutch Trial Register NTR4436; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=4436. (Archived by WebCite at http://www.webcitation.org/6zJQuSRq0)

scholarly journals The Effectiveness of a Computer-Tailored E-Learning Program for Practice Nurses to Improve Their Adherence to Smoking Cessation Counseling Guidelines: Randomized Controlled Trial (Preprint)

2017 ◽  
Author(s):  
Dennis de Ruijter ◽  
Math Candel ◽  
Eline Suzanne Smit ◽  
Hein de Vries ◽  
Ciska Hoving
Keyword(s):  
Smoking Cessation ◽  
Guideline Adherence ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Learning Program ◽  
Related Factors ◽  
Counseling Experience ◽  
Behavioral Predictors ◽  
E Learning

BACKGROUND Improving practice nurses’ (PN) adherence to smoking cessation counseling guidelines will benefit the quality of smoking cessation care and will potentially lead to higher smoking abstinence rates. However, support programs to aid PNs in improving their guideline uptake and adherence do not exist yet. OBJECTIVE The aim of this study was to assess the effects of a novel computer-tailored electronic learning (e-learning) program on PNs’ smoking cessation guideline adherence. METHODS A Web-based randomized controlled trial (RCT) was conducted in which an intervention group (N=147) with full access to the e-learning program for 6 months was compared with a control group (N=122) without access. Data collection was fully automated at baseline and 6-month follow-up via online questionnaires, assessing PNs’ demographics, work-related factors, potential behavioral predictors based on the I-Change model, and guideline adherence. PNs also completed counseling checklists to retrieve self-reported counseling activities for each consultation with a smoker (N=1175). To assess the program’s effectiveness in improving PNs’ guideline adherence (ie, overall adherence and adherence to individual counseling guideline steps), mixed linear and logistic regression analyses were conducted, thus accommodating for the smokers being nested within PNs. Potential effect moderation by work-related factors and behavioral predictors was also examined. RESULTS After 6 months, 121 PNs in the intervention group (82.3%, 121/147) and 103 in the control group (84.4%, 103/122) completed the follow-up questionnaire. Mixed linear regression analysis revealed that counseling experience moderated the program’s effect on PNs’ overall guideline adherence (beta=.589; 95% CI 0.111-1.068; PHolm-Bonferroni =.048), indicating a positive program effect on adherence for PNs with a more than average level of counseling experience. Mixed logistic regression analyses regarding adherence to individual guideline steps revealed a trend toward moderating effects of baseline levels of behavioral predictors and counseling experience. More specifically, for PNs with less favorable scores on behavioral predictors (eg, low baseline self-efficacy) and high levels of counseling experience, the program significantly increased adherence. CONCLUSIONS Results from our RCT showed that among PNs with more than average counseling experience, the e-learning program resulted in significantly better smoking cessation guideline adherence. Experienced PNs might have been better able to translate the content of our e-learning program into practically applicable counseling strategies compared with less experienced colleagues. Less favorable baseline levels of behavioral predictors among PNs possibly contributed to this effect, as there was more room for improvement by consulting the tailored content of the e-learning program. To further substantiate the effectiveness of e-learning programs on guideline adherence by health care professionals (HCPs), it is important to assess how to support a wider range of HCPs. CLINICALTRIAL Netherlands Trial Register NTR4436; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=4436 (Archived by WebCite at http://www.webcitation.org/6zJQuSRq0)

Smoking Cessation Therapy is a Cost-Effective Intervention to Avoid Tooth Loss in Subjects With Periodontitis – An Economic Evaluation 

2021 ◽  
Author(s):  
Maria Luisa Silveira Souto ◽  
Fernanda Campos Almeida Carrer ◽  
Mariana Minatel Braga ◽  
Cláudio Mendes Pannuti
Keyword(s):  
Smoking Cessation ◽  
Cost Effectiveness ◽  
Oral Health ◽  
Incremental Cost ◽  
Tooth Loss ◽  
Cost Effective ◽  
Cost Utility ◽  
Health Related ◽  
Per Oral ◽  
Smoking Cessation Therapy

Abstract Background: Smokers present a higher prevalence and severity of periodontitis and, consequently, higher prevalence of tooth loss. Smoking cessation improves the response to periodontal treatment and reduces tooth loss. So, the aim of this study was evaluated the efficiency in resources allocation when implementing smoking cessation therapy vs. its non-implementation in smokers with periodontitis. Methods: We adopted the Brazilian public system perspective to determine the incremental cost-effectiveness (cost per tooth loss avoided) and cost-utility (cost per oral-related quality-adjusted life-year ([QALY] gained) of implementing smoking cessation therapy. Base-case was defined as a 48 years-old male subject and horizon of 30 years. Effects and costs were combined in a decision analytic modeling framework to permit a quantitative approach aiming to estimate the value of the consequences of smoking cessation therapy adjusted for their probability of occurrence. Markov models were carried over annual cycles. Sensitivity analysis tested methodological assumptions. Results: Implementation of smoking cessation therapy had an average incremental cost of U$60.58 per tooth loss avoided and U$4.55 per oral related-QALY gained. Considering uncertainties, the therapy could be cost-effective in the most part of simulated cases, even being cheaper and more effective in 53% of cases in which the oral-health related outcome is used as effect. Considering a willingness-to-pay of US$100 per health effect, smoking cessation therapy was cost-effective, respectively, in 81% and 100% of cases in cost-utility and cost-effectiveness analyses. Conclusions: Implementation of smoking cessation therapy may be cost-effective, considering the avoidance of tooth loss and oral health-related consequences to patients.

scholarly journals Gaining insight into the implementation of an e-learning smoking cessation course in Latin American countries

2020 ◽  
Author(s):  
Ana Vides-Porras ◽  
Paula Cáceres ◽  
Assumpta Company ◽  
Olga Guillen ◽  
Martha Alicia Arrien ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Latin American ◽  
Tobacco Consumption ◽  
Evaluation Study ◽  
Continuous Medical Education ◽  
Learning Program ◽  
Middle Income ◽  
Technical Problems ◽  
Promote Smoking Cessation ◽  
E Learning

Abstract Continuous medical education focused on health problems emerging in low- and middle-income countries (LMICs) is scarce. Although tobacco consumption is increasing in LMICs, there is a lack of tobacco cessation training programs in these countries. To promote smoking cessation interventions in Bolivia, Guatemala and Paraguay, we adapted an e-learning program developed in Catalonia (Spain). This process evaluation study reports on reach, dose and satisfaction of participants with the course, as well as the contextual factors of its application. We conducted a multiple method evaluation, which included a survey and several focus groups, each one specific to the same type of healthcare professional (nurses, doctors, other professionals). Two hundred and ninety-two participants registered into the online course. The motivation for undertaking the course was different between doctors and nurses. The main sources of difficulty in enrolling and finishing the course were the technical problems experienced when accessing the platform, and lack of acquaintance with computers and the Internet in general. Our results show that implementing e-learning education in hospitals from LMICs is feasible, especially when there are similarities between participating countries and the country in which the original program was developed. However, several elements such as strong organizational commitment, technical support and resources and adequate communication channels should be provided to facilitate enrollment and training completion. Efforts to improve Internet access should be made to avoid jeopardizing students’ motivation to enroll and complete online training.

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