The impact of smoking cessation on patient quality of life

Sales, Maria Penha Uchoa; Oliveira, Maria Irenilza; Mattos, Isabela Melo; Viana, Cyntia Maria Sampaio; Pereira, Eanes Delgado Barros

doi:10.1590/s1806-37132009000500008

Cited by 27 publications

(25 citation statements)

References 15 publications

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“…Although this might imply an increased burden on the participant, it might be needed to establish the intervention’s cost-utility in an as certain as possible way. However, as previous studies were able to detect a positive association between quitting smoking and quality of life during a 12-month follow-up period [62,63], additional explanations for this finding need to be sought. One such explanation might be that within Dutch general practices, care as usual for smoking cessation is rather intensive.…”

Section: Discussionmentioning

confidence: 95%

Cost-Effectiveness and Cost-Utility of Internet-Based Computer Tailoring for Smoking Cessation

Smit¹,

Evers²,

Vries³

et al. 2013

J Med Internet Res

135

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BackgroundAlthough effective smoking cessation interventions exist, information is limited about their cost-effectiveness and cost-utility.ObjectiveTo assess the cost-effectiveness and cost-utility of an Internet-based multiple computer-tailored smoking cessation program and tailored counseling by practice nurses working in Dutch general practices compared with an Internet-based multiple computer-tailored program only and care as usual.MethodsThe economic evaluation was embedded in a randomized controlled trial, for which 91 practice nurses recruited 414 eligible smokers. Smokers were randomized to receive multiple tailoring and counseling (n=163), multiple tailoring only (n=132), or usual care (n=119). Self-reported cost and quality of life were assessed during a 12-month follow-up period. Prolonged abstinence and 24-hour and 7-day point prevalence abstinence were assessed at 12-month follow-up. The trial-based economic evaluation was conducted from a societal perspective. Uncertainty was accounted for by bootstrapping (1000 times) and sensitivity analyses.ResultsNo significant differences were found between the intervention arms with regard to baseline characteristics or effects on abstinence, quality of life, and addiction level. However, participants in the multiple tailoring and counseling group reported significantly more annual health care–related costs than participants in the usual care group. Cost-effectiveness analysis, using prolonged abstinence as the outcome measure, showed that the mere multiple computer-tailored program had the highest probability of being cost-effective. Compared with usual care, in this group €5100 had to be paid for each additional abstinent participant. With regard to cost-utility analyses, using quality of life as the outcome measure, usual care was probably most efficient.ConclusionsTo our knowledge, this was the first study to determine the cost-effectiveness and cost-utility of an Internet-based smoking cessation program with and without counseling by a practice nurse. Although the Internet-based multiple computer-tailored program seemed to be the most cost-effective treatment, the cost-utility was probably highest for care as usual. However, to ease the interpretation of cost-effectiveness results, future research should aim at identifying an acceptable cutoff point for the willingness to pay per abstinent participant.

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Section: Discussionmentioning

confidence: 95%

Cost-Effectiveness and Cost-Utility of Internet-Based Computer Tailoring for Smoking Cessation

Smit¹,

Evers²,

Vries³

et al. 2013

J Med Internet Res

135

View full text Add to dashboard Cite

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“…Among the 19 studies that utilize validated QoL measures, there is a consistent finding that achieving smoking cessation is associated with improved QoL ( p < .05) . Domains that are specifically improved in quitters include physical function, role‐function, pain, general health perception, vitality, social function, role‐emotional, self‐control, and mental health ( p < .02 for all) .…”

Section: Methodsmentioning

confidence: 91%

“…Domains that are specifically improved in quitters include physical function, role‐function, pain, general health perception, vitality, social function, role‐emotional, self‐control, and mental health ( p < .02 for all) . The most impacted domains seem to be role‐emotional ( p = .008), general health ( p = .006), vitality ( p < .001), and mental health ( p = .002) . Ex‐smokers also report significant improvements in mental domain scores with quitting and this may be explained by improvements in role functioning that are due to emotional problems (all p < .001) and social functioning ( p = .010) .…”

Section: Methodsmentioning

confidence: 98%

Quality of life and smoking

2014

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“…Negative effects on role-emotional and general mental health subscales of SF-36 have been previously demonstrated in patients who smoke. 49 Furthermore, smoking cessation programs using behavioral modification along with bupropion or nicotine replacement have resulted in improved physical healthand mental health-related quality of life. 49,61 Therefore, we encourage a comprehensive smoking cessation program in patients with chordoma who are current smokers at the time of diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Determinants of quality of life in patients with skull base chordoma

Diaz

Maggacis

Zhang

et al. 2014

JNS

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Object Skull base chordomas can be managed by surgical intervention and adjuvant radiotherapy. As survival for this disease increases, identification of determinants of quality of life becomes an important focus for guiding comprehensive patient care. In this study the authors sought to measure functional outcome and quality of life in patients with skull base chordomas and to identify determinants of quality of life in these patients. Methods The authors carried out an internet-based cross-sectional survey, collecting detailed data for 83 individual patients. Demographic and clinical variables were evaluated. Functional outcomes were determined by Karnofsky Performance Scale (KPS) and Glasgow Outcome Scale Extended (GOSE), quality of life was measured using the 36-Item Short Form Health Survey (SF-36), and depression was assessed using Patient Health Questions–9 (PHQ-9) instrument. Caregiver burden was assessed using the Zarit Burden Interview (ZBI). Univariate and multivariate analysis was performed to identify determinants of the physical and mental components of the SF-36. Results Patients with skull base chordomas who have undergone surgery and/or radiation treatment had a median KPS score of 90 (range 10–100, IQR 10) and a median GOSE score of 8 (range 2–8, IQR 3). The mean SF-36 Physical Component Summary score (± SD) was 43.6 ± 11.8, the mean Mental Component Summary score was 44.2 ±12.6, and both were significantly lower than norms for the general US population (p < 0.001). The median PHQ-9 score was 5 (range 0–27, IQR 8). A PHQ-9 score of 10 or greater, indicating moderate to severe depression, was observed in 29% of patients. The median ZBI score was 12 (range 0–27, IQR 11), indicating a low burden. Neurological deficit, use of pain medication, and requirement for corticosteroids were found to be associated with worse SF-36 Physical Component Summary score, while higher levels of depression (higher PHQ-9 score) correlated with worse SF-36 Mental Component Summary score. Conclusions Patients with skull base chordomas have a lower quality of life than the general US population. The most significant determinants of quality of life in the posttreatment phase in this patient population were neurological deficits (sensory deficit and bowel/bladder dysfunction), pain medication use, corticosteroid use, and levels of depression as scored by PHQ-9.

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The impact of smoking cessation on patient quality of life

Cited by 27 publications

References 15 publications

Cost-Effectiveness and Cost-Utility of Internet-Based Computer Tailoring for Smoking Cessation

Cost-Effectiveness and Cost-Utility of Internet-Based Computer Tailoring for Smoking Cessation

Quality of life and smoking

Determinants of quality of life in patients with skull base chordoma

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