Document Detail

National trends in the provision of smoking cessation aids within the Veterans Health Administration.
MedLine Citation:
PMID:  15726855     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To evaluate the effectiveness of the Veterans Health Administration (VHA) in providing treatment for tobacco dependence, accomplished by estimating national trends in the number and percent of smokers receiving smoking cessation aids (SCAs) within the VHA, trends in SCA utilization and expenditures, and the impact of lifting restrictions on patient access to SCAs. STUDY DESIGN AND METHODS: All patients receiving an outpatient SCA prescription were identified within the Veterans Affairs (VA) Pharmacy Benefits Management database over a 4-year period- October 1, 1998 (n = 61 968) to September 30, 2002 (n = 76 641). Smoking prevalence was based on data from the VA's 1999 Large Health Survey of Enrollees. A subsample of sites was classified as having restricted access to SCAs if patients were required to attend smoking cessation classes. Changes in annual SCA utilization rates and expenditures by SCA type and restriction status were measured to assess changes in treatment of tobacco dependence. RESULTS: Approximately 7% of smokers received SCA prescriptions, and SCAs accounted for less than 1% of the VHA's annual outpatient pharmacy budget in any given year. Following downward trends in the cost of 30-day SCA prescriptions, annual SCA expenditures per patient decreased over time. Expenditures were lower for restricted than unrestricted sites. More than two thirds of smokers who were prescribed medications received the nicotine patch, a quarter received bupropion sustained-release, and fewer than 10% received nicotine gum. CONCLUSIONS: Measures of SCA utilization and cost are low, stable, and less than the recommended rates in national smoking cessation guidelines, suggesting that this population of smokers is undertreated. Removing SCA restrictions is not prohibitively expensive and improves access to cost-effective care.
Yvonne C Jonk; Scott E Sherman; Steven S Fu; Kim W Hamlett-Berry; Mark C Geraci; Anne M Joseph
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  The American journal of managed care     Volume:  11     ISSN:  1088-0224     ISO Abbreviation:  Am J Manag Care     Publication Date:  2005 Feb 
Date Detail:
Created Date:  2005-02-24     Completed Date:  2005-03-15     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9613960     Medline TA:  Am J Manag Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  77-85     Citation Subset:  H    
Center for Chronic Disease Outcomes Research, Minneapolis VA Medical Center, One Veterans Drive 1110, Minneapolis, MN 55417, USA.
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MeSH Terms
Bupropion / administration & dosage*,  economics,  supply & distribution
Chewing Gum
Databases as Topic
Drug Utilization Review*
Hospitals, Veterans / standards*
Middle Aged
Nicotine / administration & dosage*,  economics,  supply & distribution
Pharmacy Service, Hospital / economics
Smoking / drug therapy*,  epidemiology,  prevention & control*
Smoking Cessation / economics,  methods,  statistics & numerical data*
United States / epidemiology
United States Department of Veterans Affairs
Veterans / psychology*
Reg. No./Substance:
0/Chewing Gum; 34841-39-9/Bupropion; 54-11-5/Nicotine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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