Cost-effectiveness of a nurse-delivered, inpatient smoking cessation intervention

Abstract

Randomized controlled trials have shown that inpatient tobacco cessation interventions are highly efficacious and costeffective. However, the degree to which smoking interventions implemented in nonrandomized, real-world practice settings are effective, and consequently, cost-effective, remains unclear. This study evaluated the cost-effectiveness of a nurse-delivered, inpatient smoking cessation intervention, Tobacco Tactics, compared with usual care within the context of an observational, real-world study design. In this quasiexperimental study, five Michigan hospitals (N = 1,370 patients) were assigned to implement either Tobacco Tactics or usual care during October 2011-May 2013. Statistical analysis was conducted during January 2017-February 2018. Controlling for confounding using stabilized inverse probability of treatment weights, incremental cost-effectiveness ratios were calculated and cost-effectiveness acceptability curves were generated. The per person cost of tobacco cessation services in the intervention group exceeded that of usual care ($175.52 vs. $67.80; p < .001). The intervention group had a higher propensity-adjusted self-reported quit rate compared to the control group (15.7% vs. 7.0%;

Implementing Smoking Cessation Interventions for Tobacco Users Within Oncology Settings

“…Third, the cost-effectiveness of an intensive treatment including 7 to 8 sessions of behavioral support needs to be considered. While such intensive treatment might be considered expensive, cost-effectiveness of oncology-based interventions is needed, with emerging evidence of economic benefit in cancer centers and inpatient interventions delivered by nurses . The dosage required has substantial drawbacks for a single TTS and a nurse-trained approach in relation to time and commitment.…”

Comparing, Contrasting, and Integrating Dissemination and Implementation Outcomes Included in the RE-AIM and Implementation Outcomes Frameworks

“…This aligns with the importance of a wide range of cost considerations used by policy makers and organizational leaders ( 16 ). The area of cost assessment and analysis in dissemination and implementation science is emerging ( 16 , 19 ) and the expanded cost metrics provide a methodology for assessing costs related to reach, adoption, implementation, and organizational maintenance—with a focus on both the strategies used to enhance each outcome and the operational costs associated with each dimension. This will allow for the development of cost simulation models ( 28 ) that could vary dissemination and implementation strategy use and provide variable budget impact scenarios for systems considering the uptake of a new evidence-based intervention.…”

“…Gaps identified across the RE-AIM framework and the IOF were also considered and addressed through a proposed expansion of the operational definitions of RE-AIM indicators. Specifically, while cost and adaptation have both been discussed and examined in the context of both frameworks—methods to operationalize both have been limited ( 4 , 7 , 16 – 19 ). Framework operational definitions based on the cross tabular comparisons are shown in Table 2 .…”

A selective review of smoking cessation interventions in the emergency department

“…ED providers frequently lack knowledge and training in smoking cessation; however, the skillset is easy to acquire and could potentially be implemented in future curricula. Lastly, nurse-delivered inpatient smoking cessation interventions have been successful and cost-effective, demonstrating the ability for non-physicians to share the responsibility for addressing tobacco control [85].…”