An updated algorithm for choosing among smoking cessation treatments

Hughes, John R.

doi:10.1016/j.jsat.2013.01.011

Cited by 30 publications

(19 citation statements)

References 61 publications

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“…Given the benefits of cessation, such caveats should rarely prevent use of nicotine replacement therapy. 9,10 A 2013 meta-analysis of treatment-specific reviews in the Cochrane Database reported an odds ratio (OR) of 1.84 (95% confidence interval [CI] 1.71-1.99) for nicotine replacement therapy versus placebo.…”

Section: What Medications Can Help Patients To Quit Smoking?mentioning

confidence: 99%

Managing smoking cessation

Reid

Pritchard

Walker

et al. 2016

CMAJ

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Section: What Medications Can Help Patients To Quit Smoking?mentioning

confidence: 99%

Managing smoking cessation

Reid

Pritchard

Walker

et al. 2016

CMAJ

View full text Add to dashboard Cite

“…5,23-27 However, we detected no effect of the AQC on measures of duration of use, including receipt of 90 or more days of pharmacotherapy among users or receipt of more than one counseling visit among users, despite evidence that higher-intensity treatments are often more effective than lower-intensity treatments. 5,28 Our findings that the AQC increased the probability of cessation treatment use relative to a comparison group of BCBSMA enrollees suggest that the incentives inherent in a multi-year global payment contract for providers to prioritize use of services with the potential to lower the future disease burden within a population such as tobacco cessation therapies led to greater provision of these services. These incentives drove changes in utilization patterns even in the absence of specific outpatient cessation performance metrics.…”

Section: Discussionmentioning

confidence: 86%

Effects of Global Payment and Accountable Care on Tobacco Cessation Service Use: An Observational Study

et al. 2016

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BACKGROUND: Tobacco use is the leading cause of preventable death and disability. New payment and delivery system models including global payment and accountable care have the potential to increase use of cost-effective tobacco cessation services. OBJECTIVE: To examine how the Alternative Quality Contract (AQC) established in 2009 by Blue Cross Blue Shield of Massachusetts (BCBSMA) has affected tobacco cessation service use. DESIGN: We used 2006-2011 BCBSMA claims and enrollment data to compare adults 18-64 years in AQC provider organizations to adults in non-AQC provider organizations. We examined the AQC's effects on all enrollees; a subset at high risk of tobacco-related complications due to certain medical conditions; and behavioral health service users. MAIN MEASURES: We examined use of: (1) any cessation treatment (pharmacotherapy or counseling); (2) varenicline or bupropion; (3) nicotine replacement therapies (NRTs); (4) cessation counseling; and (4) combination therapy (pharmacotherapy plus counseling). We also examined duration of pharmacotherapy use and number of counseling visits among users. KEY RESULTS: Rates of tobacco cessation treatment use were higher following implementation of the AQC relative to the comparison group overall (2.02 vs. 1.87 %, p < 0.0001), among enrollees at risk for tobacco-related complications (4.97 vs. 4.66 %, p < 0.0001), and among behavioral health service users (3.67 vs. 3.25 %, p < 0.0001). Statistically significant increases were found for use of varenicline or bupropion alone, counseling alone, and combination therapy, but not for NRT use, pharmacotherapy duration, or number of counseling visits among users. CONCLUSIONS: In its initial three years, the AQC was associated with increases in use of tobacco cessation services.

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“…Therefore, it is of considerable public health importance that such populations benefit from smoking cessation treatments. Further, it is important to determine whether person factors (e.g., gender, race) or smoking-related factors (e.g., tobacco dependence) might effectively guide treatment selection or allocation (Hughes, 2013; Loh et al, 2012). …”

Section: Introductionmentioning

confidence: 99%

Toward precision smoking cessation treatment I: Moderator results from a factorial experiment

Piper

Schlam

Cook

et al. 2017

Drug and Alcohol Dependence

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Background The development of tobacco use treatments that are effective for all smokers is critical to improving clinical and public health. The Multiphase Optimization Strategy (MOST) uses highly efficient factorial experiments to evaluate multiple intervention components for possible inclusion in an optimized tobacco use treatment. Factorial experiments permit analyses of the influence of patient characteristics on main and interaction effects of multiple, relatively discrete, intervention components. This study examined whether person-factor and smoking characteristics moderated the main or interactive effects of intervention components on 26-week self-reported abstinence rates. Methods This fractional factorial experiment evaluated six smoking cessation intervention components among primary care patients (N=637): Prequit Nicotine Patch vs. None, Prequit Nicotine Gum vs. None, Preparation Counseling vs. None, Intensive Cessation In-Person Counseling vs. Minimal, Intensive Cessation Telephone Counseling vs. Minimal, and 16 vs. 8 Weeks of Combination Nicotine Replacement Therapy (NRT; nicotine patch + nicotine gum). Results Both psychiatric history and smoking heaviness moderated intervention component effects. In comparison with participants with no self-reported history of a psychiatric disorder, those with a positive history showed better response to 16- vs. 8-weeks of combination NRT, but a poorer response to counseling interventions. Also, in contrast to light smokers, heavier smokers showed a poorer response to counseling interventions. Conclusions Heavy smokers and those with psychiatric histories demonstrated a differential response to intervention components. This research illustrates the use of factorial designs to examine the interactions between person characteristics and relatively discrete intervention components. Future research is needed to replicate these findings.

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An updated algorithm for choosing among smoking cessation treatments

Cited by 30 publications

References 61 publications

Managing smoking cessation

Managing smoking cessation

Effects of Global Payment and Accountable Care on Tobacco Cessation Service Use: An Observational Study

Toward precision smoking cessation treatment I: Moderator results from a factorial experiment

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