Cost-effectiveness of electronic- and clinician-delivered screening, brief intervention and referral to treatment for women in reproductive health centers.
Addiction
; 114(9): 1659-1669, 2019 09.
Article
em En
| MEDLINE
| ID: mdl-31111591
ABSTRACT
AIMS:
To determine the cost-effectiveness of electronic- and clinician-delivered SBIRT (Screening, Brief Intervention and Referral to Treatment) for reducing primary substance use among women treated in reproductive health centers.DESIGN:
Cost-effectiveness analysis based on a randomized controlled trial.SETTING:
New Haven, CT, USA.PARTICIPANTS:
A convenience sample of 439 women seeking routine care in reproductive health centers who used cigarettes, risky amounts of alcohol, illicit drugs or misused prescription medication.INTERVENTIONS:
Participants were randomized to enhanced usual care (EUC, n = 151), electronic-delivered SBIRT (e-SBIRT, n = 143) or clinician-delivered SBIRT (SBIRT, n = 145). MEASUREMENTS The primary outcome was days of primary substance abstinence during the 6-month follow-up period. To account for the possibility that patients might substitute a different drug for their primary substance during the 6-month follow-up period, we also considered the number of days of abstinence from all substances. Incremental cost-effectiveness ratios and cost-effectiveness acceptability curves determined the relative cost-effectiveness of the three conditions from both the clinic and patient perspectives.FINDINGS:
From a health-care provider perspective, e-SBIRT is likely (with probability greater than 0.5) to be cost-effective for any willingness-to-pay value for an additional day of primary-substance abstinence and an additional day of all-substance abstinence. From a patient perspective, EUC is most likely to be the cost-effective intervention when the willingness to pay for an additional day of abstinence (both primary-substance and all-substance) is less than $0.18 and e-SBIRT is most likely to be the cost-effective intervention when the willingness to pay for an additional day of abstinence (both primary-substance and all-substance) is greater than $0.18.CONCLUSIONS:
e-SBIRT could be a cost-effective approach, from both health-care provider and patient perspectives, for use in reproductive health centers to help women reduce substance misuse.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Contexto em Saúde:
1_ASSA2030
/
2_ODS3
/
8_ODS3_consumo_sustancias_psicoactivas
Problema de saúde:
1_financiamento_saude
/
2_sustancias_psicoativas
/
8_alcohol
/
8_cannabis_related_disorders
/
8_cocaine_other_stimulant_related_disorders
Assunto principal:
Encaminhamento e Consulta
/
Programas de Rastreamento
/
Diagnóstico por Computador
/
Pessoal de Saúde
/
Transtornos Relacionados ao Uso de Substâncias
/
Entrevista Motivacional
Tipo de estudo:
Clinical_trials
/
Diagnostic_studies
/
Health_economic_evaluation
/
Prognostic_studies
/
Screening_studies
Aspecto:
Patient_preference
Limite:
Female
/
Humans
Idioma:
En
Revista:
Addiction
Assunto da revista:
TRANSTORNOS RELACIONADOS COM SUBSTANCIAS
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Estados Unidos