@Article{信息:doi 10.2196 / / jmir。3975，作者=“Richter, Kimber P和Shireman, Theresa I和Ellerbeck, Edward F和Cupertino, A Paula和Catley, Delwyn和Cox, Lisa Sanderson和Preacher, christopher J和Spaulding, Ryan和Mussulman, Laura M和Nazir, Niaman和Hunt, Jamie J和Lambart, Leah”，标题=“远程医疗与电话戒烟咨询的比较和成本效益”，期刊=“J Med Internet Res”，年=“2015”，月=“May”，日=“08”，卷=“17”，数=“5”，页=“e113”，关键词= "远程医疗;互联网;农村;戒烟，随机对照试验;背景:在美国农村，吸烟很普遍，卫生保健提供者缺乏时间和资源来帮助吸烟者戒烟。电话戒烟热线是农村地区获得戒烟服务的重要途径，但它们与当地卫生保健资源的结合程度很差。目的:本研究的目的是评估远程提供专家烟草治疗的两种模式的比较效果和成本效益:一种是整合到吸烟者初级保健诊所的远程医疗咨询(综合远程医疗-ITM)，另一种是在吸烟者家中提供的电话咨询，类似于电话戒烟咨询(电话)。方法:吸烟者(n=566)从堪萨斯州的20个初级保健和安全网诊所中招募。 They were randomly assigned to receive 4 sessions of ITM or 4 sessions of Phone counseling. Patients in ITM received real-time video counseling, similar to Skype, delivered by computer/webcams in clinic exam rooms. Three full-time equivalent trained counselors delivered the counseling. The counseling duration and content was the same in both groups and was available in Spanish or English. Both groups also received identical materials and assistance in selecting and obtaining cessation medications. The primary outcome was verified 7-day point prevalence smoking abstinence at month 12, using an intent-to-treat analysis. Results: There were no significant baseline differences between groups, and the trial achieved 88{\%} follow-up at 12 months. Verified abstinence at 12 months did not significantly differ between ITM or Phone (9.8{\%}, 27/280 vs 12{\%}, 34/286; P=.406). Phone participants completed somewhat more counseling sessions than ITM (mean 2.6, SD 1.5 vs mean 2.4, SD 1.5; P=.0837); however, participants in ITM were significantly more likely to use cessation medications than participants in Phone (55.9{\%}, 128/280 vs 46.1{\%}, 107/286; P=.03). Compared to Phone participants, ITM participants were significantly more likely to recommend the program to a family member or friend (P=.0075). From the combined provider plus participant (societal) perspective, Phone was significantly less costly than ITM. Participants in ITM had to incur time and mileage costs to travel to clinics for ITM sessions. From the provider perspective, counseling costs were similar between ITM (US {\$}45.46, SD 31.50) and Phone (US {\$}49.58, SD 33.35); however, total provider costs varied widely depending on how the clinic space for delivering ITM was valued. Conclusions: Findings did not support the superiority of ITM over telephone counseling for helping rural patients quit smoking. ITM increased utilization of cessation pharmacotherapy and produced higher participant satisfaction, but Phone counseling was significantly less expensive. Future interventions could combine elements of both approaches to optimize pharmacotherapy utilization, counseling adherence, and satisfaction. Such an approach could commence with a telemedicine-delivered clinic office visit for pharmacotherapy guidance, and continue with telephone or real-time video counseling delivered via mobile phones to flexibly deliver behavioral support to patients where they most need it---in their homes and communities. Trial Registration: Clinicaltrials.gov NCT00843505; http://clinicaltrials.gov/ct2/show/NCT00843505 (Archived by WebCite at http://www.webcitation.org/6YKSinVZ9). ", issn="1438-8871", doi="10.2196/jmir.3975", url="//www.mybigtv.com/2015/5/e113/", url="https://doi.org/10.2196/jmir.3975" }