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

PATIENT EDUCATION AND COUNSELING

卷:102

Article; Proceedings Paper

de Ruijter, Dennis¹  Hoving, Ciska¹  Evers, Silvia^2,3  Hudales, Raesita¹  de Vries, Hein¹  Smit, Eline⁴ 

[1] Maastricht Univ, Dept Hlth Promot, POB 616, NL-6200 MD Maastricht, Netherlands

[2] Maastricht Univ, Dept Hlth Serv Res, POB 616, NL-6200 MD Maastricht, Netherlands

[3] Natl Inst Mental Hlth & Addict, Ctr Econ Evaluat, Trimbos Inst, POB 725, NL-3500 AS Utrecht, Netherlands

[4] Univ Amsterdam, Dept Commun Sci, POB 15791, NL-1001 NG Amsterdam, Netherlands

关键词: Economic evaluation;    E-learning;    Tailoring;    Practice nurses;    Smoking cessation;    Evidence-Based guideline;    Guideline adherence;    General practice;   

DOI  :  10.1016/j.pec.2019.07.015

来源: Elsevier

【 摘 要 】

Objective: To conduct an economic evaluation of a tailored e-learning program, which successfully improved practice nurses' smoking cessation guideline adherence. 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 (sic)1,586. On patient level, cost-effectiveness was slightly likely after six months (cost per additional quitter: (sic)7,126), but not after twelve months. The cost-utility analysis revealed slight cost-effectiveness (cost per QALY gained: (sic)18,431) on patient level. Conclusion: Providing practice nurses with a tailored e-learning program is cost-effective to improve their smoking cessation counseling. Though, cost-effectiveness on patient level was not found after twelve months, potentially resulting from smoking relapse. Practice implications: 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. (C) 2019 Elsevier B.V. All rights reserved.

【 授权许可】

Free