Systematic critical review of previous economic evaluations of smoking cessation during pregnancy

Objective: To identify and critically assess previous economic evaluations of smoking cessation interventions delivered during pregnancy. Design: Qualitative review of studies with primary data collection or hypothetical modelling. Quality assessed using the Quality of Health Economic Studies che...

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Main Authors:	Jones, Matthew, Lewis, Sarah, Parrott, Steve, Coleman, Tim
Format:	Article
Language:	English
Published:	BMJ Publishing Group Ltd 2015
Online Access:	http://eprints.nottingham.ac.uk/31210/ http://eprints.nottingham.ac.uk/31210/ http://eprints.nottingham.ac.uk/31210/ http://eprints.nottingham.ac.uk/31210/1/BMJ%20Open-2015-Jones-.pdf

id	nottingham-31210
recordtype	eprints
spelling	nottingham-312102018-06-26T12:31:27Z http://eprints.nottingham.ac.uk/31210/ Systematic critical review of previous economic evaluations of smoking cessation during pregnancy Jones, Matthew Lewis, Sarah Parrott, Steve Coleman, Tim Objective: To identify and critically assess previous economic evaluations of smoking cessation interventions delivered during pregnancy. Design: Qualitative review of studies with primary data collection or hypothetical modelling. Quality assessed using the Quality of Health Economic Studies checklist. Data sources: Electronic search of 13 databases including Medline, Econlit, Embase, and PubMed, and manual search of the UK's National Institute of Health and Care Excellence guidelines and US Surgeon General. Eligibility criteria for selecting studies: All study designs considered if they were published in English, evaluated a cessation intervention delivered to pregnant women during pregnancy, and reported any relevant economic evaluation metric (eg, cost per quitter, incremental cost per quality adjusted life year). Results: 18 studies were included. 18 evaluations were conducted alongside clinical trials, four were part of observational studies, five were hypothetical decision-analytic models and one combined modelling with within-trial analysis. Analyses conducted were cost-offset (nine studies), cost-effectiveness (five studies), cost-utility (two studies), and combined cost-effectiveness and cost-utility (two studies). Six studies each were identified as high, fair and poor quality, respectively. All interventions were demonstrated to be cost-effective except motivational interviewing which was dominated by usual care (one study). Areas where the current literature was limited were the robust investigation of uncertainty, including time horizons that included outcomes beyond the end of pregnancy, including major morbidities for the mother and her infant, and incorporating better estimates of postpartum relapse. Conclusions: There are relatively few high quality economic evaluations of cessation interventions during pregnancy. The majority of the literature suggests that such interventions offer value for money; however, there are methodological issues that require addressing, including investigating uncertainty more robustly, utilising better estimates for postpartum relapse, extending beyond a within-pregnancy time horizon, and including major morbidities for the mother and her infant for within-pregnancy and beyond. BMJ Publishing Group Ltd 2015-11-13 Article PeerReviewed application/pdf en http://eprints.nottingham.ac.uk/31210/1/BMJ%20Open-2015-Jones-.pdf Jones, Matthew and Lewis, Sarah and Parrott, Steve and Coleman, Tim (2015) Systematic critical review of previous economic evaluations of smoking cessation during pregnancy. BMJ Open, 5 (11). e008998. ISSN 2044-6055 http://bmjopen.bmj.com/content/5/11/e008998.full doi:10.1136/bmjopen-2015-008998 doi:10.1136/bmjopen-2015-008998
repository_type	Digital Repository
institution_category	Local University
institution	University of Nottingham Malaysia Campus
building	Nottingham Research Data Repository
collection	Online Access
language	English
description	Objective: To identify and critically assess previous economic evaluations of smoking cessation interventions delivered during pregnancy. Design: Qualitative review of studies with primary data collection or hypothetical modelling. Quality assessed using the Quality of Health Economic Studies checklist. Data sources: Electronic search of 13 databases including Medline, Econlit, Embase, and PubMed, and manual search of the UK's National Institute of Health and Care Excellence guidelines and US Surgeon General. Eligibility criteria for selecting studies: All study designs considered if they were published in English, evaluated a cessation intervention delivered to pregnant women during pregnancy, and reported any relevant economic evaluation metric (eg, cost per quitter, incremental cost per quality adjusted life year). Results: 18 studies were included. 18 evaluations were conducted alongside clinical trials, four were part of observational studies, five were hypothetical decision-analytic models and one combined modelling with within-trial analysis. Analyses conducted were cost-offset (nine studies), cost-effectiveness (five studies), cost-utility (two studies), and combined cost-effectiveness and cost-utility (two studies). Six studies each were identified as high, fair and poor quality, respectively. All interventions were demonstrated to be cost-effective except motivational interviewing which was dominated by usual care (one study). Areas where the current literature was limited were the robust investigation of uncertainty, including time horizons that included outcomes beyond the end of pregnancy, including major morbidities for the mother and her infant, and incorporating better estimates of postpartum relapse. Conclusions: There are relatively few high quality economic evaluations of cessation interventions during pregnancy. The majority of the literature suggests that such interventions offer value for money; however, there are methodological issues that require addressing, including investigating uncertainty more robustly, utilising better estimates for postpartum relapse, extending beyond a within-pregnancy time horizon, and including major morbidities for the mother and her infant for within-pregnancy and beyond.
format	Article
author	Jones, Matthew Lewis, Sarah Parrott, Steve Coleman, Tim
spellingShingle	Jones, Matthew Lewis, Sarah Parrott, Steve Coleman, Tim Systematic critical review of previous economic evaluations of smoking cessation during pregnancy
author_facet	Jones, Matthew Lewis, Sarah Parrott, Steve Coleman, Tim
author_sort	Jones, Matthew
title	Systematic critical review of previous economic evaluations of smoking cessation during pregnancy
title_short	Systematic critical review of previous economic evaluations of smoking cessation during pregnancy
title_full	Systematic critical review of previous economic evaluations of smoking cessation during pregnancy
title_fullStr	Systematic critical review of previous economic evaluations of smoking cessation during pregnancy
title_full_unstemmed	Systematic critical review of previous economic evaluations of smoking cessation during pregnancy
title_sort	systematic critical review of previous economic evaluations of smoking cessation during pregnancy
publisher	BMJ Publishing Group Ltd
publishDate	2015
url	http://eprints.nottingham.ac.uk/31210/ http://eprints.nottingham.ac.uk/31210/ http://eprints.nottingham.ac.uk/31210/ http://eprints.nottingham.ac.uk/31210/1/BMJ%20Open-2015-Jones-.pdf
first_indexed	2018-09-06T12:07:11Z
last_indexed	2018-09-06T12:07:11Z
_version_	1610859813697224704

Systematic critical review of previous economic evaluations of smoking cessation during pregnancy

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