title: Economic evaluation of a telephone- and face-to-face-delivered counseling intervention for smoking cessation in patients with coronary heart disease.
abstract: OBJECTIVE
  This study examined the cost-effectiveness and cost-utility of two smoking cessation counseling interventions differing in their modality for patients diagnosed with coronary heart disease from a societal perspective.
  
  
  METHODS
  In a randomized controlled trial conducted in Dutch hospital wards, cardiac patients who smoked prior to admission were allocated to usual care (n = 245), telephone counseling (n = 223) or face-to-face counseling (n = 157). The counseling interventions lasted for 3 months and were complemented by nicotine patches. Baseline histories were obtained, and interviews took place 6 months after hospitalization to assess self-reported smoking status and quality adjusted life years (QALYs). Incremental cost-effectiveness ratios per quitter and cost-utility ratios per QALY were calculated and presented in acceptability curves. Uncertainty was accounted for by sensitivity analysis.
  
  
  RESULTS
  Using continued abstinence as the outcome measure showed that telephone counseling had the highest probability of being cost-effective. Face-to-to-face counseling was also more cost-effective than usual care. No significant improvements and differences in QALYs between the three conditions were found. Varying costs and effect estimations revealed that the results of the primary analyses were robust.
  
  
  CONCLUSIONS
  Assuming a willingness-to-pay of €20,000 per abstinent patient, telephone counseling would be a highly cost-effective smoking cessation intervention assisting cardiac patients to quit. However, the lack of consensus concerning the willingness-to-pay per quitter impedes drawing firm conclusions. Moreover, studies with extended follow-up periods are needed to capture late relapses and possible differences in QALYs.
authors: Faculty of Psychology and Educational Sciences, Open University of the Netherlands, POB 2960, 6401 DL, Heerlen, The Netherlands. nadine.berndt@igss.etat.lu.|Cellule d'expertise médicale, Inspection générale de la sécurité sociale, Le Gouvernement du Grand-Duché de Luxembourg, POB 1308, 1013, Luxembourg, Luxembourg. nadine.berndt@igss.etat.lu.
authors: Nadine
authors: N
authors: Berndt
authors: Faculty of Psychology and Educational Sciences, Open University of the Netherlands, POB 2960, 6401 DL, Heerlen, The Netherlands.
authors: Catherine
authors: C
authors: Bolman
authors: Faculty of Psychology and Educational Sciences, Open University of the Netherlands, POB 2960, 6401 DL, Heerlen, The Netherlands.
authors: Lilian
authors: L
authors: Lechner
authors: Institute for Health and Aging, Department of Social and Behavioral Sciences, University of California, San Francisco, 3333 California Street, Suite 340, San Francisco, CA, 94118, USA.
authors: Wendy
authors: W
authors: Max
authors: Faculty of Psychology and Educational Sciences, Open University of the Netherlands, POB 2960, 6401 DL, Heerlen, The Netherlands.
authors: Aart
authors: A
authors: Mudde
authors: Department of Health Promotion, School for Public Health and Primary Care (CAPHRI), Maastricht University, POB 616, 6200 MD, Maastricht, The Netherlands.
authors: Hein
authors: H
authors: de Vries
authors: Department of Health Services Research, School for Public Health and Primary Care (CAPHRI), Maastricht University, POB 616, 6200 MD, Maastricht, The Netherlands.|Department of Public Mental Health, Trimbos Institute, Netherlands Institute of Mental Health and Addiction, POB 725, 3500 AS, Utrecht, The Netherlands.
authors: Silvia
authors: S
authors: Evers
mesh_terms: D000328:Adult; D000368:Aged; D003327:Coronary Disease / Q000453:epidemiology*; D003362:Cost-Benefit Analysis; D003376:Counseling / Q000191:economics* / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017059:Models, Econometric; D009426:Netherlands; D019057:Quality-Adjusted Life Years; D012907:Smoking / Q000453:epidemiology*; D016540:Smoking Cessation / Q000379:methods*; D012959:Socioeconomic Factors; D013689:Telephone; D061485:Tobacco Use Cessation Devices
keywords: Coronary heart disease; Economic evaluation; Face-to-face counseling; Quality of life; Smoking cessation; Telephone counseling