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National trends in the provision of smoking cessation aids within the Veterans Health Administration.
Am J Manag Care. 2005 Feb; 11(2):77-85.AJ

Abstract

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.

Authors+Show Affiliations

Center for Chronic Disease Outcomes Research, Minneapolis VA Medical Center, One Veterans Drive 1110, Minneapolis, MN 55417, USA. yjonk@umn.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

15726855

Citation

Jonk, Yvonne C., et al. "National Trends in the Provision of Smoking Cessation Aids Within the Veterans Health Administration." The American Journal of Managed Care, vol. 11, no. 2, 2005, pp. 77-85.
Jonk YC, Sherman SE, Fu SS, et al. National trends in the provision of smoking cessation aids within the Veterans Health Administration. Am J Manag Care. 2005;11(2):77-85.
Jonk, Y. C., Sherman, S. E., Fu, S. S., Hamlett-Berry, K. W., Geraci, M. C., & Joseph, A. M. (2005). National trends in the provision of smoking cessation aids within the Veterans Health Administration. The American Journal of Managed Care, 11(2), 77-85.
Jonk YC, et al. National Trends in the Provision of Smoking Cessation Aids Within the Veterans Health Administration. Am J Manag Care. 2005;11(2):77-85. PubMed PMID: 15726855.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - National trends in the provision of smoking cessation aids within the Veterans Health Administration. AU - Jonk,Yvonne C, AU - Sherman,Scott E, AU - Fu,Steven S, AU - Hamlett-Berry,Kim W, AU - Geraci,Mark C, AU - Joseph,Anne M, PY - 2005/2/25/pubmed PY - 2005/3/16/medline PY - 2005/2/25/entrez SP - 77 EP - 85 JF - The American journal of managed care JO - Am J Manag Care VL - 11 IS - 2 N2 - 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. SN - 1088-0224 UR - https://www.unboundmedicine.com/medline/citation/15726855/National_trends_in_the_provision_of_smoking_cessation_aids_within_the_Veterans_Health_Administration_ L2 - https://www.ajmc.com/pubMed.php?pii=2807 DB - PRIME DP - Unbound Medicine ER -