Evaluation of a complex healthcare intervention to increase smoking cessation in pregnant women: interrupted time series analysis with economic evaluation.
Tob Control
; 27(1): 90-98, 2018 01.
Article
em En
| MEDLINE
| ID: mdl-28202783
ABSTRACT
OBJECTIVES:
To evaluate the effectiveness of a complex intervention to improve referral and treatment of pregnant smokers in routine practice, and to assess the incremental costs to the National Health Service (NHS) per additional woman quitting smoking.DESIGN:
Interrupted time series analysis of routine data before and after introducing the intervention, within-study economic evaluation.SETTING:
Eight acute NHS hospital trusts and 12 local authority areas in North East England.PARTICIPANTS:
37 726 records of singleton delivery including 10 594 to mothers classified as smoking during pregnancy.INTERVENTIONS:
A package of measures implemented in trusts and smoking cessation services, aimed at increasing the proportion of pregnant smokers quitting during pregnancy, comprising skills training for healthcare and smoking cessation staff; universal carbon monoxide monitoring with routine opt-out referral for smoking cessation support; provision of carbon monoxide monitors and supporting materials; and an explicit referral pathway and follow-up protocol. MAIN OUTCOMEMEASURES:
Referrals to smoking cessation services; probability of quitting smoking during pregnancy; additional costs to health services; incremental cost per additional woman quitting.RESULTS:
After introduction of the intervention, the referral rate increased more than twofold (incidence rate ratio=2.47, 95% CI 2.16 to 2.81) and the probability of quitting by delivery increased (adjusted OR=1.81, 95% CI 1.54 to 2.12). The additional cost per delivery was £31 and the incremental cost per additional quit was £952; 31 pregnant women needed to be treated for each additional quitter.CONCLUSIONS:
The implementation of a system-wide complex healthcare intervention was associated with significant increase in rates of quitting by delivery.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Complicações na Gravidez
/
Fumar
/
Abandono do Hábito de Fumar
/
Prevenção do Hábito de Fumar
Tipo de estudo:
Diagnostic_studies
/
Evaluation_studies
/
Guideline
/
Health_economic_evaluation
/
Observational_studies
/
Risk_factors_studies
Limite:
Adolescent
/
Adult
/
Female
/
Humans
/
Pregnancy
País/Região como assunto:
Europa
Idioma:
En
Revista:
Tob Control
Assunto da revista:
TRANSTORNOS RELACIONADOS COM SUBSTANCIAS
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Reino Unido