Cost-effectiveness of electronic- and clinician-delivered screening, brief intervention and referral to treatment for women in reproductive health centers.
Alcoholism
/ diagnosis
Ambulatory Care Facilities
Cigarette Smoking
Cost-Benefit Analysis
Diagnosis, Computer-Assisted
/ economics
Female
Health Personnel
Humans
Mass Screening
/ economics
Motivational Interviewing
/ economics
Patient Satisfaction
Prescription Drug Misuse
Referral and Consultation
/ economics
Substance-Related Disorders
/ diagnosis
SBIRT
alcohol use disorder
cocaine use disorder
computer-based interventions
cost-effectiveness
marijuana use disorder
opioid use disorder
reproductive health
tobacco use disorder
women
Journal
Addiction (Abingdon, England)
ISSN: 1360-0443
Titre abrégé: Addiction
Pays: England
ID NLM: 9304118
Informations de publication
Date de publication:
09 2019
09 2019
Historique:
received:
30
07
2018
revised:
01
11
2018
accepted:
13
05
2019
pubmed:
22
5
2019
medline:
21
10
2020
entrez:
22
5
2019
Statut:
ppublish
Résumé
To determine the cost-effectiveness of electronic- and clinician-delivered SBIRT (Screening, Brief Intervention and Referral to Treatment) for reducing primary substance use among women treated in reproductive health centers. Cost-effectiveness analysis based on a randomized controlled trial. New Haven, CT, USA. A convenience sample of 439 women seeking routine care in reproductive health centers who used cigarettes, risky amounts of alcohol, illicit drugs or misused prescription medication. Participants were randomized to enhanced usual care (EUC, n = 151), electronic-delivered SBIRT (e-SBIRT, n = 143) or clinician-delivered SBIRT (SBIRT, n = 145). The primary outcome was days of primary substance abstinence during the 6-month follow-up period. To account for the possibility that patients might substitute a different drug for their primary substance during the 6-month follow-up period, we also considered the number of days of abstinence from all substances. Incremental cost-effectiveness ratios and cost-effectiveness acceptability curves determined the relative cost-effectiveness of the three conditions from both the clinic and patient perspectives. From a health-care provider perspective, e-SBIRT is likely (with probability greater than 0.5) to be cost-effective for any willingness-to-pay value for an additional day of primary-substance abstinence and an additional day of all-substance abstinence. From a patient perspective, EUC is most likely to be the cost-effective intervention when the willingness to pay for an additional day of abstinence (both primary-substance and all-substance) is less than $0.18 and e-SBIRT is most likely to be the cost-effective intervention when the willingness to pay for an additional day of abstinence (both primary-substance and all-substance) is greater than $0.18. e-SBIRT could be a cost-effective approach, from both health-care provider and patient perspectives, for use in reproductive health centers to help women reduce substance misuse.
Identifiants
pubmed: 31111591
doi: 10.1111/add.14668
pmc: PMC6684836
mid: NIHMS1030970
doi:
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
1659-1669Subventions
Organisme : NIDA NIH HHS
ID : R01 DA027194
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR001863
Pays : United States
Informations de copyright
© 2019 Society for the Study of Addiction.
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