The effectiveness of covering smoking cessation services for medicare beneficiaries
Geoffrey F Joyce1, Raymond Niaura, Margaret Maglione
1RAND, 1776 Main Street, Santa Monica, CA 90407-2138, USA. gjoyce@rand.org
Objective:
To examine whether reimbursement for Provider Counseling, Pharmacotherapies, and a telephone Quitline increase smoking cessation relative to Usual Care.
Study Design:
Randomized comparison trial testing the effectiveness of four smoking cessation benefits.
Setting:
Seven states that best represented the national population in terms of the proportion of those > or = 65 years of age and smoking rate.
Participants:
There were 7,354 seniors voluntarily enrolled in the Medicare Stop Smoking Program and they were followed-up for 12 months.
Intervention(S):
(1) Usual Care, (2) reimbursement for Provider Counseling, (3) reimbursement for Provider Counseling with Pharmacotherapy, and (4) telephone counseling Quitline with nicotine patch.
Main Outcome Measure:
Seven-day self-reported cessation at 6- and 12-month follow-ups.
Principal Findings:
Unadjusted quit rates assuming missing data=smoking were 10.2 percent (9.0-11.5), 14.1 percent (11.7-16.5), 15.8 percent (14.4-17.2), and 19.3 percent (17.4-21.2) at 12 months for the Usual Care, Provider Counseling, Provider Counseling + Pharmacotherapy, and Quitline arms, respectively. Results were robust to sociodemographics, smoking history, motivation, health status, and survey nonresponse. The additional cost per quitter (relative to Usual Care) ranged from several hundred dollars to $6,450.
Conclusions:
A telephone Quitline in conjunction with low-cost Pharmacotherapy was the most effective means of reducing smoking in the elderly.
More Related Videos
06:55Inverse Probability of Treatment Weighting (Propensity Score) using the Military Health System Data Repository and National Death Index
Published on: January 8, 2020
09:25Methods to Evaluate Cytotoxicity and Immunosuppression of Combustible Tobacco Product Preparations
Published on: January 10, 2015
Related Concept Videos
01:29Chronic Obstructive Pulmonary Disease-V: Management
Smoking Cessation
01:30Preventive Healthcare Services
01:28Acute Coronary Syndrome IV: Interprofessional Care
01:30Chronic Obstructive Pulmonary Disease-V: Nursing Management
Assessment
01:26COPD: Management Using Bronchodilators and Corticosteroids
01:26Methods Of Healthcare Delivery System
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...