CoChat
Sign Up
Cited by 103Smoking Behavior and CessationTelemedicine and Telehealth ImplementationSubstance Abuse Treatment and Outcomes

Comparative and cost effectiveness of telemedicine versus telephone counseling for smoking cessation

Open access
Richter, Kimber P, Shireman, Theresa I, Ellerbeck, Edward F, Cupertino, A Paula, Catley, Delwyn, Cox, Lisa Sanderson, Preacher, Kristopher J, Spaulding, Ryan +4 more·2015·Journal of Medical Internet Research
DOI 10.2196/jmir.3975PMC PMC4468596
Open this paper in CoChat — free account

Abstract

BACKGROUND: In rural America, cigarette smoking is prevalent and health care providers lack the time and resources to help smokers quit. Telephone quitlines are important avenues for cessation services in rural areas, but they are poorly integrated with local health care resources. OBJECTIVE: The intent of the study was to assess the comparative effectiveness and cost effectiveness of two models for delivering expert tobacco treatment at a distance: telemedicine counseling that was integrated into smokers' primary care clinics (Integrated Telemedicine-ITM) versus telephone counseling, similar to telephone quitline counseling, delivered to smokers in their homes (Phone). METHODS: Smokers (n=566) were recruited offline from 20 primary care and safety net clinics across Kansas. They were randomly assigned to receive 4 sessions of ITM or 4 sessions of Phone counseling. Patients in ITM received real-time video counseling, similar to Skype, delivered by computer/webcams in clinic exam rooms. Three full-time equivalent trained counselors delivered the counseling. The counseling duration and content was the same in both groups and was available in Spanish or English. Both groups also received identical materials and assistance in selecting and obtaining cessation medications. The primary outcome was verified 7-day point prevalence smoking abstinence at month 12, using an intent-to-treat analysis. RESULTS: There were no significant baseline differences between groups, and the trial achieved 88% follow-up at 12 months. Verified abstinence at 12 months did not significantly differ between ITM or Phone (9.8%, 27/280 vs 12%, 34/286; P=.406). Phone participants completed somewhat more counseling sessions than ITM (mean 2.6, SD 1.5 vs mean 2.4, SD 1.5; P=.0837); however, participants in ITM were significantly more likely to use cessation medications than participants in Phone (55.9%, 128/280 vs 46.1%, 107/286; P=.03). Compared to Phone participants, ITM participants were significantly more likely to recommend the program to a family member or friend (P=.0075). From the combined provider plus participant (societal) perspective, Phone was significantly less costly than ITM. Participants in ITM had to incur time and mileage costs to travel to clinics for ITM sessions. From the provider perspective, counseling costs were similar between ITM (US $45.46, SD 31.50) and Phone (US $49.58, SD 33.35); however, total provider costs varied widely depending on how the clinic space for delivering ITM was valued. CONCLUSIONS: Findings did not support the superiority of ITM over telephone counseling for helping rural patients quit smoking. ITM increased utilization of cessation pharmacotherapy and produced higher participant satisfaction, but Phone counseling was significantly less expensive. Future interventions could combine elements of both approaches to optimize pharmacotherapy utilization, counseling adherence, and satisfaction. Such an approach could commence with a telemedicine-delivered clinic office visit for pharmacotherapy guidance, and continue with telephone or real-time video counseling delivered via mobile phones to flexibly deliver behavioral support to patients where they most need it-in their homes and communities. TRIAL REGISTRATION: Clinicaltrials.gov NCT00843505; http://clinicaltrials.gov/ct2/show/NCT00843505 (Archived by WebCite at http://www.webcitation.org/6YKSinVZ9).

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.2196/jmir.3975

Cites

25 of 25 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

1 of the 26 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. [2]Pleis JR Lucas JW Ward BW National Center for Health Statistics 2009 2015-05-05 Summary health statistics for U.S. adults: National Health Interview Survey, 2008 http://www.cdc.gov/nchs/data/series/sr_10/sr10_242.pdf 26086064

Cited by

Sorted by citations

Related

Authors
Richter, K. P., Shireman, T. I., Ellerbeck, E. F., Cupertino, A. P., Catley, D., Cox, L. S., Preacher, K. J., Spaulding, R., Mussulman, L. M., Nazir, N., Hunt, J. J., & Lambart, L.
Affiliations
  • University of Kansas Medical Center (US)
  • University of Missouri–Kansas City (US)
  • Vanderbilt University (US)
Corresponding author
Richter, Kimber P
ORCID
Venue
Journal of Medical Internet Research
Publisher
JMIR Publications Inc.
Published
2015-05-08
Volume
17
Issue
5
Pages
e113
ISSN
1438-8871 (ISSN-L)
DOI
10.2196/jmir.3975
PMC
PMC4468596
OpenAlex
W2157753771
Cited by
102
References
26
Citations by year
2026: 4 · 2025: 2 · 2024: 9 · 2023: 12 · 2022: 13 · 2021: 18 · 2020: 11 · 2019: 9 · 2018: 11 · 2017: 6 · 2016: 6 · 2015: 1
FWCI
5.89
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Journal of Medical Internet Research (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • National Institutes of Health
  • National Heart, Lung, and Blood Institute (R01HL087643)
Topics
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Keywords
telemedicine, telephone counseling, smoking cessation, telephone quitline, video counseling, rural health care, primary care integration, cost-effectiveness, smoking abstinence, cessation medications, safety-net clinics, Spanish-language services, travel cost, Kansas
MeSH terms
Adult, Ambulatory Care Facilities, Attitude of Health Personnel, Cost-Benefit Analysis, Counseling, Female, Humans, Male, Middle Aged, Primary Health Care, Rural Population, Smoking, Telephone, Tobacco Use Disorder, Smoking Cessation, Health Care Costs, Patient Satisfaction, Telemedicine, Cell Phone, Tobacco Use Cessation Devices

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review