RESUMO
BACKGROUND: Tobacco use causes hundreds of thousands of deaths in the United States each year. Pharmacists are available in the community to provide tobacco cessation interventions. Between 2004 and 2010, the New Mexico Pharmaceutical Care Foundation (NMPCF) provided a pharmacist-led tobacco cessation program to residents in New Mexico. OBJECTIVES: To (a) obtain point prevalence quit rates at 1 month, 3 months, and 6 months follow-up for participants enrolled in the NMPCF program; (b) differentiate between the quitting patterns of enrolled participants; and (c) identify predictors associated with the quitting patterns. METHODS: Seven-year data were combined for the pattern analysis. Four quitting patterns were defined, including immediate quitters, delayed quitters, once quitters, and never quitters. Multinomial logistic regression was used to identify characteristics of participants with different quitting patterns. RESULTS: The analysis included 1,437 participants. The average point prevalence quit rate at 1 month, 3 months, and 6 months was 29.3%, 23.3%, and 18.0%, respectively. Based on our definition for quitting patterns, the study sample consisted of 145 (10.1%) immediate quitters, 113 (7.9%) delayed quitters, 298 (20.7%) once quitters, and 881 (61.3%) never quitters. Multinomial logistic regression identified associations between quitting patterns and demographics, tobacco use and restrictions, baseline confidence in successful quitting, and pharmacotherapy aids used to quit. Relationships varied between quitting patterns. CONCLUSIONS: The study findings showed that having community pharmacists provide smoking cessation interventions resulted in quitting success rates similar to other health care professionals, which ranged from 9.9% to 26.0%. Since pharmacists are a widely available resource for their patients, managed care organizations may be able to improve the health, and avoid subsequent tobacco-related adverse health outcomes, of their members by implementing a program similar to the NMPCF Tobacco Cessation Program.
Assuntos
Serviços Comunitários de Farmácia , Cooperação do Paciente , Farmacêuticos , Abandono do Hábito de Fumar/métodos , Prevenção do Hábito de Fumar , Tabagismo/terapia , Adolescente , Adulto , Idoso , Feminino , Acessibilidade aos Serviços de Saúde , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , New Mexico/epidemiologia , Avaliação de Processos e Resultados em Cuidados de Saúde , Papel Profissional , Avaliação de Programas e Projetos de Saúde , Recidiva , Fumar/efeitos adversos , Fumar/epidemiologia , Fatores de Tempo , Tabagismo/epidemiologia , Resultado do Tratamento , Adulto JovemRESUMO
OBJECTIVE: To determine health care costs associated with pressure ulcers, ulcers of the lower limbs, other chronic ulcers, and venous leg ulcers from the New Mexico Medicaid fee-for-service program perspective. DESIGN: Retrospective analysis of claims database MAIN OUTCOME MEASURES: Physician visit, hospital, and prescription costs were determined for New Mexico Medicaid patients with a primary and/or secondary diagnosis of 1 of 4 identified categories of skin ulcers from January 1, 1994, through December 31, 1998. Costs were determined in terms of mean and median annual cost per patient and total costs per year. Zero dollar claims were included within the cost calculations. All costs are expressed in 2000-dollar values. MAIN RESULTS: Mean annual physician visit costs per patient ranged from $71 (standard deviation [SD] = $60) for venous leg ulcers in 1998 to $520 (SD = $1228) for pressure ulcers in 1996. Mean annual hospital costs per patient ranged from $266 (SD = $348) for other chronic ulcers in 1998 to $15,760 (SD = $30,706) for pressure ulcers in 1998. Mean annual prescription costs per patient ranged from $145 (SD = $282) for other chronic ulcers in 1998 to $654 (SD = $1488) for pressure ulcers in 1994. CONCLUSION: The New Mexico Medicaid fee-for-service system incurred a total cost of approximately $11.6 million (in 2000 dollars) from 1994 through 1998 for the treatment of the 4 categories of skin ulcers studied. The data showed that the majority of wounds were coded as pressure ulcers, which had the highest associated costs.