Department of Health Promotion, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, the Netherlands.
Department of Health Promotion, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, the Netherlands.
Patient Educ Couns. 2019 Oct;102(10):1802-1811. doi: 10.1016/j.pec.2019.07.015. Epub 2019 Jul 30.
To conduct an economic evaluation of a tailored e-learning program, which successfully improved practice nurses' smoking cessation guideline adherence.
The economic evaluation was embedded in a randomized controlled trial, in which 269 practice nurses recruited 388 smoking patients. Cost-effectiveness was assessed using guideline adherence as effect measure on practice nurse level, and continued smoking abstinence on patient level. Cost-utility was assessed on patient level, using patients' Quality Adjusted Life Years (QALYs) as effect measure.
The e-learning program was likely to be cost-effective on practice nurse level, as adherence to an additional guideline step cost €1,586. On patient level, cost-effectiveness was slightly likely after six months (cost per additional quitter: €7,126), but not after twelve months. The cost-utility analysis revealed slight cost-effectiveness (cost per QALY gained: €18,431) on patient level.
Providing practice nurses with a tailored e-learning program is cost-effective to improve their smoking cessation counseling. Though, cost-effectiveness on patient level was not found after twelve months, potentially resulting from smoking relapse.
Widespread implementation of the e-learning program can improve the quality of smoking cessation care in general practice. Strategies to prevent patients' smoking relapse should be further explored to improve patients' long-term abstinence.
对一项定制化电子学习计划进行经济评估，该计划成功提高了执业护士对戒烟指南的依从性。
经济评估嵌入一项随机对照试验中，其中 269 名执业护士招募了 388 名吸烟患者。在执业护士层面，使用指南依从性作为效果衡量指标，在患者层面，使用继续戒烟的持续率作为效果衡量指标，评估成本效果。在患者层面，使用患者的质量调整生命年（QALY）作为效果衡量指标，评估成本效用。
电子学习计划在执业护士层面上可能具有成本效益，因为额外遵循一个指南步骤的成本为 1586 欧元。在六个月后，患者层面的成本效果略有可能（每增加一个戒烟者的成本：7126 欧元），但在十二个月后则不然。成本效用分析显示患者层面存在轻微的成本效益（每获得一个 QALY 的成本：18431 欧元）。
为执业护士提供定制化的电子学习计划可提高其戒烟咨询的成本效益。然而，在十二个月后，患者层面的成本效果并不明显，这可能是由于患者的吸烟复发。
广泛实施电子学习计划可以提高一般实践中戒烟护理的质量。应进一步探索预防患者吸烟复发的策略，以提高患者的长期戒烟率。
