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BukuCost-Effectiveness of Motivational Interviewing for Smoking Cessation and Relapse Prevention among Low-Income PregnantWomen:A Randomized Controlled Trial(in the International Society for Pharmacoeconomics and Outcomes Research)
Bibliografi
Author: Ruger, Jennifer Prah ; Weinstein, Milton C. ; Hammond, S. Katherine ; Kearney, Margaret H. ; Emmons, Karen M.
Topik: Cost-Effectiveness; Low-Income; Pregnant Women; Relapse Prevention; Smoking Cessation
Bahasa: (EN )    
Tahun Terbit: 2007    
Jenis: Article - diterbitkan di jurnal ilmiah internasional
Fulltext: SSRN-id1078262[1].pdf (144.0KB; 5 download)
Abstract
Objectives: Low-income women have high rates of smoking
during pregnancy, but little is known about the costs, benefits,
and cost-effectiveness of motivational interviewing
(MI), focused on the medical and psychosocial needs of this
population, as an intervention for smoking cessation and
relapse prevention.
Methods: A sample of 302 low-income pregnant women was
recruited from multiple obstetrical sites in the Boston metropolitan
area into a randomized controlled trial of a motivational
intervention for smoking cessation and relapse
prevention versus usual care (UC). The findings of this clinical
trial were used to estimate the costs, benefits, and costeffectiveness
of the intervention from a societal perspective,
incorporating published quality-adjusted life-year (QALY)
and life-year (LY) estimates. Outcomes included smoking
cessation and relapse, maternal and infant outcomes, economic
costs, LYs and QALYs saved, and incremental costeffectiveness
ratios.
Results: The cost-effectiveness of MI for relapse prevention
compared to UC was estimated to be $851/LY saved and
$628/QALY saved. Including savings in maternal medical
costs in sensitivity analyses resulted in cost savings for MI for
relapse prevention compared to UC. For smoking cessation,
MI cost more but did not provide additional benefit compared
to UC. In one-way sensitivity analyses, the incremental costeffectiveness
of MI versus UC would have been $117,100/LY
saved and $86,300/QALY saved if 8% of smokers had quit. In
two-way sensitivity analyses, MI was still relatively costeffective
for relapse prevention ($17,300/QALY saved) even if
it cost as much as $2000/participant and was less effective. For
smoking cessation, however, a higher level of effectiveness
(9/110) and higher cost ($400/participant) resulted in higher
incremental cost-effectiveness ratios ($112,000/QALY).
Conclusions: Among low-income pregnant women, MI
helps prevent relapse at relatively low cost, and may be
cost-saving when net medical cost savings are considered. For
smoking cessation, MI cost more but provided no additional
benefit compared to UC, but might offer benefits at costs
comparable to other clinical preventive interventions if
8–10% of smokers are induced to quit.
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