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Title: A systematic review of economic evaluations of preoperative smoking cessation for preventing surgical complications.
Epworth Authors: Cunningham, John E.
Other Authors: McGaffrey, Nikki
Higgins, Julie
Greenhalgh, Elizabeth
White, Sarah L.
Graves, Nicholas
Myles, Paul S.
Dean, Emma
Doncovio, Sally
Briggs, Lisa
Lal, Anita
Keywords: Cost-effective Analysis
Health Economics
Smoking Cessation
Cost-Benefit Analysis
Epworth Musculoskeletal Clinical Institute
Epworth Neurosciences Clinical Institute, Epworth HealthCare, Victoria, Australia
Issue Date: Aug-2022
Publisher: Elsevier
Citation: Int J Surg. 2022 Aug;104:106742.
Abstract: generally, the benefits of routinely providing smoking cessation for surgical populations are less well known. This review summarises the evidence on the cost-effectiveness of preoperative smoking cessation to prevent surgical complications. Materials and methods: A search of the Cochrane, Econlit, EMBASE, Health Technology Assessment, Medline Complete and Scopus databases was conducted from inception until June 23, 2021. Peer-reviewed, Englishlanguage articles describing economic evaluations of preoperative smoking cessation interventions to prevent surgical complications were included. Search results were independently screened for potentially eligible studies. Study characteristics, economic evaluation methods and cost-effectiveness results were extracted by one reviewer and details checked by a second. Two authors independently assessed reporting and methodological quality using the Consolidated Health Economic Evaluation Reporting Standards statement (CHEERS) and the Quality of Health Economic Studies Instrument checklist (QHES) respectively. Results: After removing duplicates, twenty full text articles were screened from 1423 database records, resulting in six included economic evaluations. Studies from the United States (n = 4), France (n = 1) and Spain (n = 1) were reported between 2009 and 2020. Four evaluations were conducted from a payer perspective. Two-thirds of evaluations were well-conducted (mean score 83) and well-reported (on average, 86% items reported). All studies concluded preoperative smoking cessation is cost-effective for preventing surgical complications; results ranged from cost saving to €53,131 per quality adjusted life year gained. Conclusions: Preoperative smoking cessation is cost-effective for preventing surgical complications from a payer or provider perspective when compared to standard care. There is no evidence from outside the United States and Europe to inform healthcare providers, funders and policy-makers in other jurisdictions and more information is needed to clarify the optimal point of implementation to maximise cost-effectiveness of preoperative smoking cessation intervention. Systematic review registration number: PROSPERO 2021 CRD42021257740. Research registry registration number: reviewregistry1369.
PubMed URL:
ISSN: 1743-9191
Journal Title: International Journal of Surgery
Type: Journal Article
Affiliated Organisations: Deakin University, Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Geelong, Victoria, Australia
Cancer Council Victoria, Melbourne, Victoria, Australia
Deakin University, Geelong, Australia
Health Services & Systems Research, Duke-NUS Medical School, Singapore
Department of Anaesthesiology and Perioperative Medicine, Alfred Hospital and Monash University, Melbourne, Australia
Prevention and Population Health Branch, Department of Health, Victoria, Australia
TOGA and Rare Cancers, Australia
Type of Clinical Study or Trial: Systematic Reviews
Appears in Collections:Musculoskeletal

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