North American Research & Analysis, Inc, 1016 11th Ave NE, Faribault, MN 55021, USA.
Int J Environ Res Public Health. 2011 May;8(5):1547-59. doi: 10.3390/ijerph8051547. Epub 2011 May 13.
Many tobacco cessation quitlines provide nicotine replacement therapy (NRT) in the U.S. but consensus is lacking regarding the best shipping protocol or NRT amounts. We evaluated the impact of the Minnesota QUITPLAN(®) Helpline's shift from distributing NRT using a single eight-week shipment to a two-shipment protocol. For this observational study, the eight week single-shipment cohort (n = 247) received eight weeks of NRT (patches or gum) at once, while the split-shipment cohort (n = 160) received five weeks of NRT (n = 94), followed by an additional three weeks of NRT if callers continued with counseling (n = 66). Patient satisfaction, retention, quit rates, and cost associated with the three groups were compared. A higher proportion of those receiving eight weeks of NRT, whether in one or two shipments, reported that the helpline was "very helpful" (77.2% of the single-shipment group; 81.1% of the two-shipment group) than those receiving five weeks of NRT (57.8% of the one-shipment group) (p = 0.004). Callers in the eight week two-shipment group completed significantly more calls (3.0) than callers in the five week one-shipment group (2.4) or eight week single-shipment group (1.7) (p < 0.001). Using both responder and intent-to-treat calculations, there were no significant differences in 30-day point prevalence abstinence at seven months among the three protocol groups even when controlling for demographic and tobacco use characteristics, and treatment group protocol. The mean cost per caller was greater for the single-shipment phase than the split-shipment phase ($350 vs. $326) due to the savings associated with not sending a second shipment to some participants. Assuming no difference in abstinence rates resulting from the protocol change, cost-per-quit was lowest for the five week one-shipment group ($1,155), and lower for the combined split-shipment cohort ($1,242) than for the single-shipment cohort ($1,350). Results of this evaluation indicate that while satisfaction rates increase among those receiving more counseling and NRT, quit rates do not, even when controlling for demographic and tobacco use characteristics.
许多美国的戒烟热线提供尼古丁替代疗法（NRT），但对于最佳发货方案或 NRT 用量，尚未达成共识。我们评估了明尼苏达州 QUITPLAN（®）热线从分发 NRT 的单疗程（八周）转变为双疗程发货方案的影响。在这项观察性研究中，八周单疗程队列（n = 247）一次性接受八周 NRT（贴片或口香糖），而分疗程队列（n = 160）前五周接受 NRT（n = 94），如果呼叫者继续接受咨询，再额外提供三周 NRT（n = 66）。比较了三组的患者满意度、保留率、戒烟率和成本。无论是接受单疗程（8 周）还是双疗程（8 周）NRT，报告热线“非常有帮助”的比例更高（单疗程组为 77.2%；双疗程组为 81.1%），而非接受五周 NRT 的比例（单疗程组为 57.8%）（p = 0.004）。在八周双疗程组中，完成的电话咨询量（3.0）明显多于五周单疗程组（2.4）或八周单疗程组（1.7）（p < 0.001）。即使控制了人口统计学和吸烟特征以及治疗组方案，在 7 个月时，使用应答者和意向治疗计算方法，三种方案组的 30 天点预存率在七个月时并无显著差异。在单疗程阶段，每位呼叫者的平均费用高于分疗程阶段（$350 比 $326），这是因为避免向一些参与者发送第二份疗程带来的节省。假设方案改变导致的戒烟率没有差异，五周单疗程组（$1155）的每戒烟一人成本最低，且低于双疗程组（$1242），而高于单疗程组（$1350）。这项评估的结果表明，尽管接受更多咨询和 NRT 的人满意度有所提高，但戒烟率并没有提高，即使控制了人口统计学和吸烟特征。
