scholarly journals Cost-Effectiveness Analysis Of Text Messaging To Support Health Advice For Smoking Cessation 

2020 ◽  
Author(s):  
Raquel Cobos-Campos ◽  
Javier Mar ◽  
Antxon Apiñaniz ◽  
Arantza Sáez de Lafuente ◽  
Naiara Parraza ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Smoking Cessation ◽  
Cost Effectiveness ◽  
Markov Model ◽  
Text Messaging ◽  
Health Care Cost ◽  
Cost Effective ◽  
Text Messages ◽  
Health Advice

Abstract Background: Smoking in one of the most serious public health problems. It is well known that it constitutes a major risk factor for chronic diseases and the leading cause of preventable death worldwide.Due to high prevalence of smokers, new cost-effective strategies seeking to increase smoking cessation rates are needed. Methods: We performed a Markov model-based cost-effectiveness analysiscomparing two treatments: health advice provided by general practitioners and nurses in primary care, and health advice reinforced by sending motivational text messages to smokers’mobile phones. A Markov model was used in which smokerstransitioned between three mutually exclusive health states (smoker, former smoker and dead) after 6-month cycles. We calculated the cost-effectiveness ratio associated with the sending of motivational messages. Health care and society perspectives (separately) was adopted. Costs taken into account were direct health care costs and direct health care cost and costsfor lost productivity, respectively.Additionally, deterministic sensitivity analysis was performed modifying the probability of smoking cessation with each option. Results: Sending of text messages as a tool to support health advice was found to be cost-effective as it was associated with increases in costs of €7.4 and €1,327 per QALY gained (ICER)for men and women respectively from a healthcare perspective, significantly far from the published cost-effectiveness threshold. From a societal perspective, the combined programmed was dominant. Conclusions: Sending text messages is a cost-effective approach. These findings support the implantation of the combined program across primary care health centres.

scholarly journals Cost-Effectiveness Analysis Of Text Messaging To Support Health Advice For Smoking Cessation 

2020 ◽  
Author(s):  
Raquel Cobos-Campos ◽  
Javier Mar ◽  
Antxon Apiñaniz ◽  
Arantza Sáez de Lafuente ◽  
Naiara Parraza ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Smoking Cessation ◽  
Cost Effectiveness ◽  
Text Messaging ◽  
Cost Effective ◽  
Cost Effectiveness Analysis ◽  
Text Messages ◽  
Effectiveness Analysis ◽  
Health Advice

Abstract Background: Smoking in one of the most serious public health problems. It is well known that it constitutes a major risk factor for chronic diseases and the leading cause of preventable death worldwide.Due to high prevalence of smokers, new cost-effective strategies seeking to increase smoking cessation rates are needed. Methods:We performed a cost-effectiveness analysis comparing two treatments: health advice provided by general practitioners and nurses in primary care, and health advice reinforced by sending motivational text messages to patients’ mobile phones. A Markov model was used in which patients transitioned between three mutually exclusive health states (smoker, former smoker and dead) after 6-month cycles. We calculated the cost-effectiveness ratio associated with the sending of motivational messages throughout a patient’s life. Health care and society perspectives (separately) was adopted. Costs taken into account were direct health care costs and direct health care cost and costsfor lost productivity, respectively.Additionally, deterministic sensitivity analysis was performed modifying the probability of smoking cessation with each option. Results:Sending of text messages as a tool to support health advice was found to be cost-effective as it was associated with increases in costs of €7.4 and €1,327 per QALY gained for men and women respectively from a healthcare perspective, significantly far from the published cost-effectiveness threshold. From a societal perspective, the combined programmed was dominant. Conclusions: Sending text messages is a cost-effective approach. These findings support the implantation of the combined program across primary care health centres.

scholarly journals Cost-effectiveness analysis of text messaging to support health advice for smoking cessation

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Raquel Cobos-Campos ◽  
Javier Mar ◽  
Antxon Apiñaniz ◽  
Arantza Sáez de Lafuente ◽  
Naiara Parraza ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Smoking Cessation ◽  
Cost Effectiveness ◽  
Markov Model ◽  
Cost Effective ◽  
Cost Effectiveness Analysis ◽  
Text Messages ◽  
Effectiveness Analysis ◽  
Health Advice

Abstract Background Smoking in one of the most serious public health problems. It is well known that it constitutes a major risk factor for chronic diseases and the leading cause of preventable death worldwide. Due to high prevalence of smokers, new cost-effective strategies seeking to increase smoking cessation rates are needed. Methods We performed a Markov model-based cost-effectiveness analysis comparing two treatments: health advice provided by general practitioners and nurses in primary care, and health advice reinforced by sending motivational text messages to smokers’ mobile phones. A Markov model was used in which smokers transitioned between three mutually exclusive health states (smoker, former smoker and dead) after 6-month cycles. We calculated the cost-effectiveness ratio associated with the sending of motivational messages. Health care and society perspectives (separately) was adopted. Costs taken into account were direct health care costs and direct health care cost and costs for lost productivity, respectively. Additionally, deterministic sensitivity analysis was performed modifying the probability of smoking cessation with each option. Results Sending of text messages as a tool to support health advice was found to be cost-effective as it was associated with increases in costs of €7.4 and €1,327 per QALY gained (ICUR) for men and women respectively from a healthcare perspective, significantly far from the published cost-effectiveness threshold. From a societal perspective, the combined programmed was dominant. Conclusions Sending text messages is a cost-effective approach. These findings support the implantation of the combined program across primary care health centres.

scholarly journals Cost-effectiveness Analysis of Text Messaging to Support Health Advice for Smoking Cessation

2020 ◽  
Author(s):  
Raquel Cobos-Campos ◽  
Javier Mar ◽  
Antxon Apiñaniz ◽  
Arantza Sáez de Lafuente ◽  
Naiara Parraza ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Smoking Cessation ◽  
Cost Effectiveness ◽  
Markov Model ◽  
Cost Effective ◽  
Cost Effectiveness Analysis ◽  
Text Messages ◽  
Effectiveness Analysis ◽  
Health Advice

Abstract Background: Smoking in one of the most serious public health problems. It is well known that it constitutes a major risk factor for chronic diseases and the leading cause of preventable death worldwide. Due to high prevalence of smokers, new cost-effective strategies seeking to increase smoking cessation rates are needed.Methods: We performed a Markov model-based cost-effectiveness analysis comparing two treatments: health advice provided by general practitioners and nurses in primary care, and health advice reinforced by sending motivational text messages to smokers’ mobile phones. A Markov model was used in which smokers transitioned between three mutually exclusive health states (smoker, former smoker and dead) after 6-month cycles. We calculated the cost-effectiveness ratio associated with the sending of motivational messages. Health care and society perspectives (separately) was adopted. Costs taken into account were direct health care costs and direct health care cost and costs for lost productivity, respectively. Additionally, deterministic sensitivity analysis was performed modifying the probability of smoking cessation with each option.Results: Sending of text messages as a tool to support health advice was found to be cost-effective as it was associated with increases in costs of €7.4 and €1,327 per QALY gained (ICER) for men and women respectively from a healthcare perspective, significantly far from the published cost-effectiveness threshold. From a societal perspective, the combined programmed was dominant.Conclusions: Sending text messages is a cost-effective approach. These findings support the implantation of the combined program across primary care health centres.

Continuation of Anti-TNF in Patients With Ulcerative Colitis in Remission Is Not Cost-effective Compared With Treatment Withdrawal: A Markov Model

2020 ◽  
Author(s):  
Remi Mahmoud ◽  
Chris van Lieshout ◽  
Geert W J Frederix ◽  
Bindia Jharap ◽  
Bas Oldenburg
Keyword(s):  
Ulcerative Colitis ◽  
Health Care ◽  
Cost Effectiveness ◽  
Markov Model ◽  
Cost Effective ◽  
Health Care Expenditures ◽  
Increased Risk ◽  
The Cost ◽  
Cost Effectiveness Threshold ◽  
Effectiveness Threshold

Abstract Background and Aims Anti-tumour necrosis factor alpha [anti-TNF] treatment accounts for 31% of health care expenditures associated with ulcerative colitis [UC]. Withdrawal of anti-TNF in patients with UC in remission may decrease side effects and infections, while promoting cost containment. Approximately 36% of patients relapse within 12–24 months of anti-TNF withdrawal, but reintroduction of treatment is successful in 80% of patients. We aimed to evaluate the cost-effectiveness of continuation versus withdrawal of anti-TNF in patients with UC in remission. Methods We developed a Markov model comparing cost-effectiveness of anti-TNF continuation versus withdrawal, from a health care provider perspective. Transition probabilities were calculated from literature, or estimated by an expert panel of 11 gastroenterologists. Deterministic and probabilistic sensitivity analyses were performed to account for assumptions and uncertainty. The cost-effectiveness threshold was set at an incremental cost-effectiveness ratio of €80,000 per quality-adjusted life-year [QALY]. Results At 5 years, anti-TNF withdrawal was less costly [-€10,781 per patient], but also slightly less effective [-0.04 QALY per patient] than continued treatment. Continuation of anti-TNF compared with withdrawal costs €300,390/QALY, exceeding the cost-effectiveness threshold. Continued therapy would become cost-effective if the relapse rate following anti-TNF withdrawal was ≥43% higher, or if adalimumab or infliximab [biosimilar] prices fell below €87/40 mg and €66/100 mg, respectively. Conclusions Continuation of anti-TNF in UC patients in remission is not cost-effective compared with withdrawal. A stop-and-reintroduction strategy is cost-saving but is slightly less effective than continued therapy. This strategy could be improved by identifying patients at increased risk of relapse.

Cost-Effectiveness of Early-Initiated Treatment for Advanced-Stage Epithelial Ovarian Cancer Patients: A Modeling Study

2014 ◽  
Vol 24 (1) ◽  
pp. 75-84 ◽  
Author(s):  
Tom Hoyer ◽  
Ruud Bekkers ◽  
Hein Gooszen ◽  
Leon Massuger ◽  
Maroeska Rovers ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Health Care ◽  
Cost Effectiveness ◽  
Epithelial Ovarian Cancer ◽  
Health Care Cost ◽  
Cost Effective ◽  
Current Treatment ◽  
Current Evidence ◽  
Advanced Stage ◽  
Life Years

ObjectiveBetween diagnosis and primary treatment of patients with epithelial ovarian cancer (EOC), gaps of several weeks exist. Reducing these time intervals may benefit the patient and may lead to a reduction of costs. We explored the cost-effectiveness of early-initiated treatment of patients with suspected advanced-stage EOC compared with that of current treatment.MethodsA discrete event simulation was used to synthesize all available evidences and to evaluate the health care costs and effects (quality-adjusted life years [QALYs]) of the 2 treatment strategies over lifetime. Overall survival, progression-free survival, health-related quality of life, and costs of the separate events were assumed to remain equal. Other uncertainties were addressed using deterministic and probabilistic sensitivity analyses.ResultsThe treatment times of current and early-initiated treatment were 27 and 24 weeks, respectively. Early-initiated treatment yielded 3.42 QALYs per patient, for a total expected health care cost of €25,654. Current treatment yielded 3.40 QALYs per patient, for a total expected health care cost of €25,607. This resulted in an incremental cost-effectiveness ratio of €2592 per QALY gained for early-initiated treatment compared with that for current treatment. For the willingness to pay for €30,000 or more per QALY, early-initiated treatment had a 100% probability of being cost-effective compared with current treatment under the previously mentioned assumptions.ConclusionsGiven the current evidence, early-initiated treatment of patients with suspected advanced-stage EOC leads to additional QALYs and seems to be cost-effective compared with current treatment.

scholarly journals Cost effectiveness comparison of dutasteride and finasteride in patients with benign prostatic hyperplasia - the Markov model based on data from Montenegro

2016 ◽  
Vol 73 (1) ◽  
pp. 26-33 ◽  
Author(s):  
Vera Dabanovic ◽  
Marina Kostic ◽  
Slobodan Jankovic
Keyword(s):  
Health Care ◽  
Cost Effectiveness ◽  
Benign Prostatic Hyperplasia ◽  
Markov Model ◽  
Health Care Service ◽  
Cost Effective ◽  
Prostatic Hyperplasia ◽  
Common Disease ◽  
Life Years ◽  
Effective Option

Background/Aim. Benign prostatic hyperplasia (BPH) is one of the most common disease among males aging 50 years and more. The rise of the prevalence of BPH is related to aging, and since duration of life time period has the tendency of rising the prevalence of BPH will rise as costs of BPH treatment will and its influence on health economic budget. Dutasteride is a new drug similar to finasteride, inhibits enzyme testosterone 5-alpha reductase, diminish symptoms of BPH, reduce risk of the complications and increases quality of life in patients with BPH. But, the use of dutasteride is limited by its high costs. The aim of this study was to compare cost effectiveness of dutasteride and finasteride from the perspective of a purchaser of health care service (Republic Institute for Health Insuranse, Montenegro). ??thods. We constructed a Markov model to compare cost effectivenss of dutasteride and finasteride using data from the available pharmacoeconomic literature and data about socioeconomic sphere actual in Montenegro. A time horizon was estimated to be 20 years, with the duration of 1 year per one cycle. The discount rate was 3%. We performed Monte Carlo simulation for virtual cohort of 1,000 patients with BPH. Results. The total costs for one year treatment of BPH with dutasteride were estimated to be 6,458.00 ? which was higher comparing with finasteride which were 6,088.56 ?. The gain in quality adjusted life years (QALY) were higher with dutasteride (11.97 QALY ) than with finasteride (11.19 QALY). The results of our study indicate that treating BPH with dutasteride comparing to finasteride is a cost effective option since the value of incremental cost-effectiveness ratio (ICER) is 1,245.68 ?/QALY which is below estimated threshold (1,350.00 ? per one gained year of life). Conclusion. Dutasteride is a cost effective option for treating BPH comparing to finasteride. The results of this study provide new information for health care decision makers about treatment of BPH in socioeconomic environment which is actual both in Montenegro and other countries with a recent history of socioeconomic transition.

scholarly journals Implementing Facilitated Access to a Text Messaging, Smoking Cessation Intervention Among Swedish Patients Having Elective Surgery: Qualitative Study of Patients’ and Health Care Professionals’ Perspectives (Preprint)

2019 ◽  
Author(s):  
Kristin Thomas ◽  
Marcus Bendtsen ◽  
Catharina Linderoth ◽  
Preben Bendtsen
Keyword(s):  
Health Care ◽  
Smoking Cessation ◽  
Text Messaging ◽  
Elective Surgery ◽  
Text Messages ◽  
Smoking Cessation Intervention ◽  
Motivation To Change ◽  
Cessation Intervention ◽  
Second Category ◽  
Text Messaging Intervention

BACKGROUND There is strong evidence that short-term smoking cessation before surgery can reduce postoperative morbidity. There are, however, several structural problems in health care systems concerning how to implement smoking cessation interventions in routine practice for preoperative patients. OBJECTIVE This study aimed to analyze the implementation of a text messaging, smoking cessation intervention targeting patients having elective surgery. Implementation of facilitated access (ie, referral from practitioners) and the perceived usefulness among patients were investigated. Elective surgery is defined as scheduled, nonacute surgery. METHODS A qualitative study was carried out at two medium-sized hospitals in the south of Sweden. The implementation of facilitated access was investigated during a 12-month period from April 2018 to April 2019. Facilitated access was conceptualized as specialists recommending the text messaging intervention to patients having elective surgery. Implementation was explored in terms of perceptions about the intervention and behaviors associated with implementation; that is, how patients used the intervention and how specialists behaved in facilitating usage among patients. Two focus groups with smoking cessation specialists and 10 individual interviews with patients were carried out. Qualitative content analysis was used to analyze the data. RESULTS Two main categories were identified from the focus group data with smoking cessation specialists: <i>implementation approach</i> and <i>perceptions about the intervention</i>. The first category, <i>implementation approach</i>, referred to how specialists adapted their efforts to situational factors and to the needs and preferences of patients, and how building of trust with patients was prioritized. The second category, <i>perceptions about the intervention</i>, showed that specialists thought the content and structure of the text messaging intervention felt familiar and worked well as a complement to current practice. Two categories were identified from the patient interview data: <i>incorporating new means of support from health care</i> and <i>determinants of use</i>. The first category referred to how patients adopted and incorporated the intervention into their smoking cessation journey. Patients were receptive, shared the text messages with friends and family, humanized the text messages, and used the messages as a complement to other strategies to quit smoking. The second category, <i>determinants of use</i>, referred to aspects that influenced how and when patients used the intervention and included the following: timing of the intervention and text messages, motivation to change, and perceptions of the mobile phone medium. CONCLUSIONS Smoking cessation specialists adopted an active role in implementing the intervention by adapting their approach and fitting the intervention into existing routines. Patients showed strong motivation to change and openness to incorporate the intervention into their behavior change journey; however, the timing of the intervention and messages were important in optimizing the support. A text messaging, smoking cessation intervention can be a valuable and feasible way to reach smoking patients having elective surgery.

scholarly journals Implementing Facilitated Access to a Text Messaging, Smoking Cessation Intervention Among Swedish Patients Having Elective Surgery: Qualitative Study of Patients’ and Health Care Professionals’ Perspectives

10.2196/17563 ◽  
2020 ◽  
Vol 8 (9) ◽  
pp. e17563 ◽  
Author(s):  
Kristin Thomas ◽  
Marcus Bendtsen ◽  
Catharina Linderoth ◽  
Preben Bendtsen
Keyword(s):  
Health Care ◽  
Smoking Cessation ◽  
Text Messaging ◽  
Elective Surgery ◽  
Text Messages ◽  
Smoking Cessation Intervention ◽  
Motivation To Change ◽  
Cessation Intervention ◽  
Second Category ◽  
Text Messaging Intervention

Background There is strong evidence that short-term smoking cessation before surgery can reduce postoperative morbidity. There are, however, several structural problems in health care systems concerning how to implement smoking cessation interventions in routine practice for preoperative patients. Objective This study aimed to analyze the implementation of a text messaging, smoking cessation intervention targeting patients having elective surgery. Implementation of facilitated access (ie, referral from practitioners) and the perceived usefulness among patients were investigated. Elective surgery is defined as scheduled, nonacute surgery. Methods A qualitative study was carried out at two medium-sized hospitals in the south of Sweden. The implementation of facilitated access was investigated during a 12-month period from April 2018 to April 2019. Facilitated access was conceptualized as specialists recommending the text messaging intervention to patients having elective surgery. Implementation was explored in terms of perceptions about the intervention and behaviors associated with implementation; that is, how patients used the intervention and how specialists behaved in facilitating usage among patients. Two focus groups with smoking cessation specialists and 10 individual interviews with patients were carried out. Qualitative content analysis was used to analyze the data. Results Two main categories were identified from the focus group data with smoking cessation specialists: implementation approach and perceptions about the intervention. The first category, implementation approach, referred to how specialists adapted their efforts to situational factors and to the needs and preferences of patients, and how building of trust with patients was prioritized. The second category, perceptions about the intervention, showed that specialists thought the content and structure of the text messaging intervention felt familiar and worked well as a complement to current practice. Two categories were identified from the patient interview data: incorporating new means of support from health care and determinants of use. The first category referred to how patients adopted and incorporated the intervention into their smoking cessation journey. Patients were receptive, shared the text messages with friends and family, humanized the text messages, and used the messages as a complement to other strategies to quit smoking. The second category, determinants of use, referred to aspects that influenced how and when patients used the intervention and included the following: timing of the intervention and text messages, motivation to change, and perceptions of the mobile phone medium. Conclusions Smoking cessation specialists adopted an active role in implementing the intervention by adapting their approach and fitting the intervention into existing routines. Patients showed strong motivation to change and openness to incorporate the intervention into their behavior change journey; however, the timing of the intervention and messages were important in optimizing the support. A text messaging, smoking cessation intervention can be a valuable and feasible way to reach smoking patients having elective surgery.

Effectiveness of Text Messaging as an Adjuvant to Health Advice in Smoking Cessation Programs in Primary Care. A Randomized Clinical Trial

2016 ◽  
pp. ntw300 ◽  
Author(s):  
Raquel Cobos-Campos ◽  
Antxon Apiñaniz Fernández de Larrinoa ◽  
Arantza Sáez de Lafuente Moriñigo ◽  
Naiara Parraza Diez ◽  
Felipe Aizpuru Barandiaran
Keyword(s):  
Primary Care ◽  
Clinical Trial ◽  
Smoking Cessation ◽  
Randomized Clinical Trial ◽  
Text Messaging ◽  
Health Advice

Perspectives and Views of Primary Care Professionals regarding a mHealth Intervention to Support Adherence to antidiabetic medication in People with Type 2 Diabetes in Spain: A Qualitative Study (Preprint)

2021 ◽  
Author(s):  
Rocío Zamanillo-Campos ◽  
Maria Jesús Serrano-Ripoll ◽  
Joana Maria Taltavull-Aparicio ◽  
Elena Gervilla-García ◽  
Joana Ripoll-Amengual ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Cost Effectiveness ◽  
Medication Adherence ◽  
Text Messaging ◽  
Text Messages ◽  
Antidiabetic Medication ◽  
Design And Implementation ◽  
Primary Care Professionals

BACKGROUND Type 2 Diabetes (T2D) is a long-term condition affecting 9.3% of people worldwide. People with T2D are at high risk of developing serious complications (e.g., blindness, lower-limb amputations, kidney disease, cardiovascular disease), which reduce their quality of life and life expectancy. Antidiabetic medication, if taken appropriately, is effective in preventing diabetes-related complications. However, 40% of T2D patients do not adequately adhere to their medication regimes. Brief text messages (e.g., SMS) delivered at a wide-scale and low cost via digital health systems represent a promising approach to support medication adherence. However, the views and perspectives of primary care professionals (PCP) regarding this type of intervention have seldom been explored. OBJECTIVE To explore PCPs’ views and perspectives concerning the DiabeText intervention, a new text messaging intervention currently being developed to support medication adherence in people with T2D in Mallorca (Spain). METHODS In this qualitative study, we conducted four focus groups (n=28) and eight semi-structured interviews with a purposive sample of primary care doctors and nurses with previous experience in the provision of healthcare to patients with T2D. Data collection explored the acceptability and usefulness of the DiabeText intervention and the barriers and facilitators to its development and implementation. Data analysis was carried out by researchers independently and discussed in a series of six meetings and a workshop. All data were coded by the lead author following an iterative approach. Initial notes were made, followed by a process of categorization and theme development following Braun and Clark’s methodology. RESULTS Three main themes were identified: 1) text messaging interventions have the potential to effectively support diabetes self-management (DSM); 2) Involving PCP in the intervention would facilitate its design and implementation, and; 3) obtaining evidence supporting the cost-effectiveness is a key prerequisite for large scale implementation of the intervention. PCPs drew on their knowledge and experience treating T2D patients to identify facilitators and barriers for the design and implementation of the intervention. They also made suggestions about the content and format of the text messages. PCPs identified additional areas (diet, exercise, diabetes complications, appointment reminders) that the messaging intervention should address to further support adequate DSM. CONCLUSIONS The DiabeText intervention is perceived as useful and acceptable by PCPs provided its cost-effectiveness. Involving PCPs in the design and implementation of the intervention is a key factor to optimize the potential impact of the proposed intervention.

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