Healthcare financing systems for increasing the use of tobacco dependence treatment

Cochrane Database of Systematic Reviews, 2012

Healthcare financing systems for increasing the use of tobacco dependence treatment - The Cochrane Library - Reda - Wiley Online Library from LOGIN Enter e-mail address Enter password REMEMBER ME > > > > DATABASE TOOLS DATABASE MENU FIND ARTICLES OTHER RESOURCES Intervention Review You have full text access to this content Healthcare financing systems for increasing the use of tobacco dependence treatment Ayalu A Reda 1,2 , Daniel Kotz 1 , Silvia M A A Evers 3 , Constant Paul van Schayck 4,* Editorial Group: Published Online: 13 JUN 2012 Assessed as up-to-date: 8 MAY 2012 DOI: 10.1002/14651858.CD004305.pub4 Copyright © 2012 The Cochrane Collaboration.
Publication History Publication Status: New search for studies and content updated (no change to conclusions) Published Online: 13 JUN 2012 SEARCH ARTICLE TOOLS Abstract Abstract Background We hypothesized that provision of financial assistance for smokers trying to quit, or reimbursement of their care providers, could lead to an increased rate of successful quit attempts.
Objectives The primary objective of this review was to assess the impact of reducing the costs of providing or using smoking cessation treatment through healthcare financing interventions on abstinence from smoking.
The secondary objectives were to examine the effects of different levels of financial support on the use and/or prescription of smoking cessation treatment and on the number of smokers making a quit attempt.
Selection criteria We considered randomised controlled trials (RCTs), controlled trials and interrupted time series studies involving financial benefit interventions to smokers or their healthcare providers or both.
Data collection and analysis Two reviewers independently extracted data and assessed the quality of the included studies.
Risk ratios (RR) were calculated for individual studies on an intention-to-treat basis and meta-analysis was performed using a random-effects model.
We included economic evaluations when a study presented the costs and effects of two or more alternatives.
Main results We found eleven trials involving financial interventions directed at smokers and healthcare providers.
Full financial interventions directed at smokers had a statistically significant favourable effect on abstinence at six months or greater when compared to no intervention (RR 2.45, 95% CI 1.17 to 5.12, I² = 59%, 4 studies).
There was also a significant effect of full financial interventions when compared to no interventions on the number of participants making a quit attempt (RR 1.11, 95% CI 1.04 to 1.32, I² = 15%) and use of smoking cessation treatment (NRT: RR 1.83, 95% CI 1.55 to 2.15, I² = 43%; bupropion: RR 3.22, 95% CI 1.41 to 7.34, I² = 71%; behavioural therapy: RR 1.77, 95% CI 1.19 to 2.65).