TY - JOUR AU - Mujcic, Ajla AU - Blankers, Matthijs AU - Boon, Brigitte AU - verdoneck -de Leeuw, Irma M AU - Smit, philip AU - van Laar, Margriet AU - Engels, rutgger PY - 2022 DA - 2022/3/17 TI -数字戒烟干预癌症幸存者的有效性、成本-效益和成本-效用:一项实用随机对照试验的健康经济评价和结果戒烟-癌症幸存者-有效性-成本-效益- eHealth背景:戒烟(SC)干预可能有助于更好的治疗结果和癌症幸存者的总体福祉。目的:本研究旨在评估数字交互式SC干预与非交互式基于网络的癌症幸存者信息手册的有效性、成本效益和成本效用。方法:进行健康经济评估，同时进行实用的两臂平行组随机对照试验，随访时间为3、6和12个月。该研究于2016年11月至2019年9月在荷兰通过互联网进行。参与者是有意戒烟的荷兰成年吸烟癌症幸存者。共纳入并分析了165名参与者:MyCourse组83名(50.3%)，对照组82名(49.7%)。在干预组中，参与者可以使用新开发的、数字化的、最低限度指导的SC干预(MyCourse-Quit Smoking)。对照组的参与者收到了一份基于网络的非交互式SC信息手册。两组参与者都接受了不受限制的常规护理。主要结果是在6个月的随访中自我报告的7天戒烟情况。 Secondary outcomes were quality-adjusted life years gained, number of cigarettes smoked, nicotine dependence, and treatment satisfaction. For the health economic evaluation, intervention costs, health care costs, and costs stemming from productivity losses were assessed over a 12-month horizon. Results: At the 6-month follow-up, the quit rates were 28% (23/83) and 26% (21/82) in the MyCourse and control groups, respectively (odds ratio 0.47, 95% CI 0.03-7.86; P=.60). In both groups, nicotine dependence scores were reduced at 12 months, and the number of smoked cigarettes was reduced by approximately half. The number of cigarettes decreased more over time, and the MyCourse group demonstrated a significantly greater reduction at the 12-month follow-up (incidence rate ratio 0.87; 95% CI 0.76-1.00; P=.04). Intervention costs were estimated at US $193 per participant for the MyCourse group and US $74 for the control group. The mean per-participant societal costs were US $25,329 (SD US $29,137) and US $21,836 (SD US $25,792), respectively. In the cost-utility analysis, MyCourse was not preferred over the control group from a societal perspective. With smoking behavior as the outcome, the MyCourse group led to marginally better results per reduced pack-year against higher societal costs, with a mean incremental cost-effectiveness ratio of US $52,067 (95% CI US $32,515-US $81,346). Conclusions: At 6 months, there was no evidence of a differential effect on cessation rates; in both groups, approximately a quarter of the cancer survivors quit smoking and their number of cigarettes smoked was reduced by half. At 12 months, the MyCourse intervention led to a greater reduction in the number of smoked cigarettes, albeit at higher costs than for the control group. No evidence was found for a differential effect on quality-adjusted life years. Trial Registration: The Netherlands Trial Register NTR6011; https://www.trialregister.nl/trial/5434 International Registered Report Identifier (IRRID): RR2-10.1186/s12885-018-4206-z SN - 1438-8871 UR - //www.mybigtv.com/2022/3/e27588 UR - https://doi.org/10.2196/27588 UR - http://www.ncbi.nlm.nih.gov/pubmed/35297777 DO - 10.2196/27588 ID - info:doi/10.2196/27588 ER -