Smoking cessation intervention in the community pharmacy: Cost-effectiveness of a non-randomized cluster-controlled trial at 12-months' follow-up

Jesús Carlos Gómez Martínez; Leire Gaztelurrutia Lavesa; Ana Mendoza Barbero; Javier Plaza Zamora; Montserrat Lage Piñón; Miguel Aguiló Juanola; Maite Climent Catalá; Antonieta de Andrés Dirube; Luís García Moreno; Irene Jaraiz Magariños; Montse Moral Ajado; Navidad Sánchez Marcos

doi:10.1016/j.sapharm.2023.09.003

Smoking cessation intervention in the community pharmacy: Cost-effectiveness of a non-randomized cluster-controlled trial at 12-months' follow-up

Res Social Adm Pharm. 2024 Jan;20(1):19-27. doi: 10.1016/j.sapharm.2023.09.003. Epub 2023 Sep 7.

Affiliations

¹ Respiratory and Smoking Group of the Spanish Society of Clinical, Family and Community Pharmacy, Paseo de las Delicias 31, Madrid, Spain; Spanish Society of Clinical, Family and Community Pharmacy, Paseo de las Delicias 31, Madrid, Spain.
² Respiratory and Smoking Group of the Spanish Society of Clinical, Family and Community Pharmacy, Paseo de las Delicias 31, Madrid, Spain; Spanish Society of Clinical, Family and Community Pharmacy, Paseo de las Delicias 31, Madrid, Spain. Electronic address: tabaquismo@sefac.org.es.
³ Spanish Society of Clinical, Family and Community Pharmacy, Paseo de las Delicias 31, Madrid, Spain.

PMID: 37704533
DOI: 10.1016/j.sapharm.2023.09.003

Abstract

Background: This study evaluated the cost-effectiveness of an intervention based on a training course for community pharmacists and a smoking cessation service (CESAR©), using limited societal and the health provider perspectives.

Methods: Non-randomized controlled trial of 12-months' follow-up. Spanish community pharmacists who were previously trained with CESAR© formed the intervention group (n = 102), and control group delivered usual care (n = 80). CESAR Patients were smokers identified by the community pharmacists when they attended the pharmacy. Data were self-reported. Outcomes were smoking cessation and quality-of-life (EQ-5D-3L) and were collected at baseline, 6, and 12 months. Costs data included direct health costs, work loss, and intervention costs. Smoking cessation was analyzed through logistic regression models. Generalized linear models were carried out for quality-adjusted life year (QALY) and costs. Incremental cost-effectiveness ratio (ICER) and cost-utility ratio (ICUR) were calculated.

Results: In total, 800 smoking patients were included in the intervention group and 278 in the control group. Of these, 487 and 151 patients completed the study, respectively. Costs were lower in the intervention group compared to the control group in both perspectives. At 12 months, 54.3% and 37.1% patients from the intervention and the control groups reported smoking cessation, respectively. The difference in probability of cessation in the intervention compared to the control group was 17.6% (CI:0.05; 0.25). The mean QALY was higher in the intervention group [0.03(CI: 0.01; 0.07)]. The ICER and the ICUR were dominant for the intervention group.

Conclusion: This intervention for smoking cessation showed that the CESAR© intervention, that combined a training for community pharmacists with a smoking cessation service was efficient for smoking cessation and QALY at 12 months' follow-up.

Trial registration: NCT05461066, retrospectively registered (July 15, 2022).

Keywords: Community pharmacist; Economics; Intervention; Quality of life; Smoking cessation.

Publication types

Clinical Trial
Controlled Clinical Trial

MeSH terms

Cost-Benefit Analysis
Follow-Up Studies
Humans
Pharmacies*
Pharmacists
Smoking Cessation*

Associated data

ClinicalTrials.gov/NCT05461066