Communication of personalised disease risk by general practitioners to motivate smoking cessation in England: a cost‐effectiveness and research prioritisation study.
Background and Aims: Communication of personalised disease risk can motivate smoking cessation. We assessed whether routine implementation of this intervention by general practitioners (GPs) in England is cost‐effective or whether we need further research to better establish its effectiveness. Desig...
| Publicado en: | Addiction Vol. 117; no. 5; pp. 1438 - 1450 |
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| Autores principales: | , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
May2022
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=156112704&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 156112704 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09652140 AIO jtl: Addiction issn: 09652140 maglogo: Y pubinfo: dt: May2022 vid: 117 iid: 5 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 156112704 154732164 156112704 156112704 10.1111/add.15773 156112704 ppf: 1438 ppct: 12 formats: fmt: – @attributes: type: T – @attributes: type: C – @attributes: type: P tig: atl: Communication of personalised disease risk by general practitioners to motivate smoking cessation in England: a cost‐effectiveness and research prioritisation study. aug: au: Adamson, Alexander Portas, Laura Accordini, Simone Marcon, Alessandro Jarvis, Deborah Baio, Gianluca Minelli, Cosetta affil: National Heart & Lung Institute, Imperial College London, London, UK sug: subj: Physicians, Family Psychosocial Factors Communication Methods Disease Risk Factors Risk Assessment Smoking Cessation Motivation Human Cost Benefit Analysis Research, Medical Research Priorities Adult Middle Age Quality-Adjusted Life Years Smoking Mortality Pulmonary Disease, Chronic Obstructive Lung Neoplasms Stroke Disease Economics Uncertainty Odds Ratio Credibility (Research) Sex Factors Age Factors England Adult: 19-44 years Middle Aged: 45-64 years ab: Background and Aims: Communication of personalised disease risk can motivate smoking cessation. We assessed whether routine implementation of this intervention by general practitioners (GPs) in England is cost‐effective or whether we need further research to better establish its effectiveness. Design Cost‐effectiveness analysis (CEA) with value of information (VoI) analysis from the UK National Health Service perspective, using GP communication of personalised disease risk on smoking cessation versus usual care. Setting: GP practices in England. Study population: Healthy smokers aged 35–60 years attending the GP practice. Measurements Effectiveness of GP communication of personalised disease risk on smoking cessation was estimated through systematic review and meta‐analysis. A Bayesian CEA was then performed using a lifetime Markov model on smokers aged 35–60 years that measured lifetime costs and quality‐adjusted life‐years (QALYs) assigned to the four diseases contributing the most to smoking‐related morbidity, mortality and costs: chronic obstructive pulmonary disease, lung cancer, myocardial infarction and stroke. Costs and QALYs for each disease state were obtained from the literature. VoI analysis identified sources of uncertainty in the CEA and assessed how much would be worth investing in further research to reduce this uncertainty. Findings The meta‐analysis odds ratio for the effectiveness estimate of GP communication of personalised disease risk was 1.48 (95% credibility interval, 0.91–2.26), an absolute increase in smoking cessation rates of 3.84%. The probability of cost‐effectiveness ranged 89–94% depending on sex and age. VoI analysis indicated that: (i) uncertainty in the effectiveness of the intervention was the driver of the overall uncertainty in the CEA; and (ii) a research investment to reduce this uncertainty is justified if lower than £27.6 million (£7 per smoker). Conclusions: Evidence to date shows that, in England, incorporating disease risk communication into general practitioners' practices to motivate smoking cessation is likely to be cost‐effective compared with usual care. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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