出版社：Utrecht University, Maastricht University, Groningen University
摘要：Introduction : For the treatment of smoking, health advice is considered one of the most cost-effective interventions, but the behavioural changes achieved by counselling usually do not last for a long time. Thus, it is necessary to develop alternative strategies focused on improving outcomes with programs that include reinforcement mechanisms through Information and Communications Technologies (ICTs). Short description of practice change implemented : To assess this topic, we developed a text messaging program (SMSalud®) which sent motivational messages to patients’ mobile phone to encourage them in their efforts to quit tobacco. This program was employed as a tool to reinforce the health advice provided by health care professionals. The effectiveness of this program (health advice + SMSalud®) was evaluated through a randomized clinical trial (RCT) in 320 smoker patients. We compared the percentage of quitters from combined program versus patients from clinical practice group (health advice) at 12 months, with a 16.26% and 5.6% of success respectively. This combined program will be implemented in primary care centres of Osakidetza, during next year. Aim of theory of change : Our objective is promoting changes in health related behaviour to prevent tobacco related chronic diseases. A large body of evidence supports the association between certain healthy lifestyles and lower rates of major chronic diseases and all-cause mortality. Targeted population and stakeholders : Motivated smoker patients belonging to any primary care centre of Osakidetza. Timeline : At this moment we are modifying SMSalud® program in a mobile application (Vive sin tabaco®), more attractive to patients. Transfer to clinical practice will begin in January in Araba. Training courses will be given in the management of the app, and a pilot study will be carried out. After pilot study, if there are not incidences, the program will be extended to the rest of the Basque Country in the second half of the year. Highligts : Several studies have highlighted the great potential of this technology for producing changes in health-related behaviour. Taking into account the prevalence of smoking in the Basque country, the penetration of mobile telephony, and the success rates achieved in the RCT, we have estimated a cost per quitter at 12 months of 104 euros (direct costs of program), which is a much lower than the cost of the pharmacological treatment. Comments on sustainability : A higher percentage of patients will quite tobacco, thus costs caused by smoking related diseases will decrease. That program will save costs in the future. Comments on transferability : Several services of Osakidetza are working in having this application finished in a short period of time. Once this program is implemented in routine clinical practice, the effectiveness will be reassessed. Conclussion : We think that results will be as effective in clinical practice as in the clinical trial. Due to difficulty of quitting tobacco, and the incidence of smoking related diseases, it is necessary to explore different alternatives to obtain greater success in treatments. Leason learned : ICTs have become useful tools to help smokers quit tobacco. Similar strategies could be applied to other clinical conditions.
关键词：primary care ; mobile applications ; smoking cessation
