Previously submitted to: Interactive Journal of Medical Research (no longer under consideration since Sep 12, 2019)
Date Submitted: Dec 8, 2018
Open Peer Review Period: Dec 12, 2018 - Jan 3, 2019
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An economic evaluation of a computer-tailored e-learning program to promote smoking cessation counseling guideline adherence among practice nurses
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)
Citation
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