Cost-effectiveness analysis of smoking-cessation treatment using electronic medical records in a cardiovascular hospital

Scholz, Jaqueline; Portela, Luana D.; Abe, Tania M O; Gaya, Patrícia Viviane; Santos, Vanessa G.; Ferreira, Cristina Helena Faleiros; Amorim, Clarice; Pereira, Alexandre C.; Santos, Paulo Caleb Júnior Lima

doi:10.1016/j.ctrsc.2016.01.006

Cited by 6 publications

(5 citation statements)

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“…Current research indicates that pharmacotherapy increases cessation success [ 14 – 17 ]. Previous studies, however, have indicated that NRT alone was less effective than bupropion and varenicline; and that it should be used in addition to these medications [ 18 – 20 ].…”

Section: Discussionmentioning

confidence: 99%

Effects of aging on the effectiveness of smoking cessation medication

et al. 2016

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BackgroundConsidering the pharmacokinetic and pharmacodynamic aspects of different medications, it is plausible that the age of a smoker could affect the half-life of these drugs. The aim of this study was to compare the effectiveness of smoking cessation drugs (nicotine replacement therapy, bupropion, and varenicline) used either in isolation or in combination in adults under and over 60 years of age.MethodsData were collected from 940 Brazilian patients participating in a smoking cessation program. Participants were prescribed smoking cessation medication to be used for at least 12 weeks and were followed for 52 weeks.ResultsCessation rates were significantly different among younger and older participants who were using nicotine replacement therapy (NRT) alone. Being over 60 years of age was significantly associated with increased cessation success among those who used NRT alone (OR 2.34, 95% CI: 1.36 to 4.04, p = 0.002). The effectiveness of varenicline and bupropion were not significantly different according to age groups.ConclusionUsing age as a predictor for tailoring smoking cessation drugs might potentially lead to a more individualized prescription of smoking cessation therapy. These results should be tested in randomized controlled trials.

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Section: Discussionmentioning

confidence: 99%

Effects of aging on the effectiveness of smoking cessation medication

et al. 2016

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“…The efficacy of smoking cessation is inevitably beneficial, and the cost-effectiveness of medical interventions for nicotine dependence have been well-established. 11 Although physicians of different specialties may frequently ask their patients about their smoking statuses during examination, PCPs are expectedly more likely to contribute to providing advice and counselling regarding smoking cessation. Therefore, assessment of PCPs' knowledge and attitudes is a critical part of the smoking cessation interventions, which could reduce the burden of the resultant disorders in areas with high prevalence of smoking, such as Saudi Arabia.…”

Section: Discussionmentioning

confidence: 99%

Knowledge, attitude and barriers regarding smoking cessation counseling among primary health care physicians in Jeddah, 2019

Alrufaidy¹,

Alsubhi²,

Khalifa³

et al. 2020

JCHM

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Background: Tobacco smoking is highly prevalent in Saudi Arabia, and there is a need to reduce the resultant health burden via patient-oriented smoking cessation interventions. Primary care physicians (PCPs) have a significant role in providing counselling and advice to quit smoking. Objectives: To assess knowledge and attitudes of PCPs regarding smoking cessation counselling (SCC) and to investigate the barriers and facilitators to providing SCC care. Methods: A cross-sectional study was conducted including family physicians, general practitioners (GPs), and dentists working at primary healthcare centers (PHCCs) in Jeddah, Saudi Arabia. The included PHCCs were selected via a random sampling technique, and all eligible PCPs were approached via a semi-structured, self-administered questionnaire comprising of 33 items. Results: A total of 130 physicians responded (55.4% females, 60.2% family physicians, 16.2% smokers). The median (P75) knowledge score was 5.00 (6.00) out of 10, and 36.2% of the participants had adequate knowledge. Significantly higher knowledge levels were reported among family physicians and GPs compared to dentists (p=0.004), as well as PCPs who received training on SCC (p=0.001) and those with better confidence in providing interventions (p=0.005). The majority of PCPs acknowledged the importance of SCC interventions (96.2%) and necessity to provide regular advice (90.8%). The lack of time to provide advice and follow-up were significant barriers, while being involved in SCC was reported as the main facilitator. Conclusion:There is an urgent need to promote PCPs' knowledge via suitable solutions, such as continuing medical education on SCC, digital education interventions, and specialized SCC centers.

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“…Two previous investigations on genetic markers related to better treatment outcomes were conducted with varenicline 15 and bupropion 16 considering a smoking cessation database [Programa de Assistência ao Fumante (Smoker Assistance Program)] 17 with over nine hundred smokers treated between 2007 and 2013. Santos et al 15 showed a positive relation between CHRNA4 rs1044396 polymorphism and varenicline treatment success.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of bupropion and varenicline genetic markers in choosing pharmacological treatment for smoking cessation, and implications for combining drugs: A randomized controlled trial (GENTSMOKING)

Gaya,

Santos,

Tomaz

et al. 2024

Tob. Induc. Dis.

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INTRODUCTION Smoking cessation is the best strategy for reducing tobacco-related morbimortality. The goal of this randomized controlled trial was to test whether using the genetically favorable markers to choose a smoking cessation drug treatment (precision medicine) was superior to using the most effective drug (varenicline) in terms of abstinence rates. Additionally, combination therapy was tested when monotherapy failed. METHODS This partially blind, single-center study randomized (1:1) 361 participants into two major groups. In the genetic group (n=184), CYP2B6 rs2279343 (genotype AA) participants started treatment with bupropion, and CHRNA4 rs1044396 (genotype CT or TT) participants started treatment with varenicline; when genetic favorable to both, participants started treatment with bupropion, and when favorable to neither, on both drugs. In the control group (n=177), participants started treatment with varenicline, regardless of genetic markers. Drug treatment lasted 12 weeks. Efficacy endpoints were abstinence rates at Weeks 4, and Weeks 8–12, biochemically validated by carbon monoxide in exhaled air. Participants who did not achieve complete abstinence at Week 4, regardless of group, were given the choice to receive combination therapy. RESULTS Abstinence rates were 42.9% (95% CI: 36–64) in the control group versus 30.4% (95% CI: 23–37) in the genetic group at Week 4 (p=0.01); and 74% (95% CI: 67–80) versus 52% (95% CI: 49–64) at Week 12 (p<0.001), respectively. The strategy of combining drugs after Week 4 increased abstinence rates in both groups and the significant difference between genetic and control groups was maintained. CONCLUSIONS Results show that using these selected genetic markers was inferior to starting treatment with varenicline (control group), which is currently the most effective smoking cessation drug; moreover, the addition of bupropion in cases of varenicline monotherapy failure improves the efficacy rate until the end of treatment. CLINICAL TRIAL IDENTIFIER NCT03362099

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Cost-effectiveness analysis of smoking-cessation treatment using electronic medical records in a cardiovascular hospital

Cited by 6 publications

References 14 publications

Effects of aging on the effectiveness of smoking cessation medication

Effects of aging on the effectiveness of smoking cessation medication

Knowledge, attitude and barriers regarding smoking cessation counseling among primary health care physicians in Jeddah, 2019

Efficacy of bupropion and varenicline genetic markers in choosing pharmacological treatment for smoking cessation, and implications for combining drugs: A randomized controlled trial (GENTSMOKING)

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