Randomized Trial of Four Financial-Incentive Programs for Smoking Cessation

Smoking cessation is still a heavily researched and talked about topic.  While quitting smoking may seem simple to a non-smoker, the reality is that trying to stop smoking can be a difficult and expensive choice.  This study looked at how financial incentives may increase sustained abstinence from smoking.

2,538 people enrolled in the study and were then assigned to either one of four incentive programs or the usual care for smoking cessation.  Of the the four incentive programs, two were targeted to individuals and two were targeted to groups of six.  These two groups then differentiated by being either a reward-based program or a deposit-based program (refundable deposit plus a reward).  The results of the study showed that while 90% of participants accepted the assignment when the program was reward-based, only 13.7% of participants accepted the assignment when the program was deposit-based.  After six months, rates of sustained abstinence were higher for every program (9.4% to 16.0%) than the basic care group (6.0%).  Additionally, the reward-based programs had higher abstinence rates than the deposit-based programs.

I found the results of this study surprising.  I understand that stopping smoking can be extremely difficult but I still expected the percentage of abstinence to be higher when the reward was $800 for six months of abstinence.  One of the programs had an extremely high denial rate.  It required people to deposit $150 dollars, which they would get back if they successfully completed the six months.  After seeing the results, I now understand why the amount was so low.  Incentive-programs like these do make a significant difference.  However, with the percentages being so low I find it hard to believe that anyone would fund the program without a financial incentive, which only comes from the deposit-based reward system that most smokers would not attempt.

Halpern SD, French B, Small DS, et al. Randomized Trial of Four Financial-Incentive Programs for Smoking Cessation. N Engl J Med. 2015;372(22):2108-117.

http://www.nejm.org/doi/full/10.1056/NEJMoa1414293#t=articleMethods

Developing school-pharmacist partnerships to enhance correct medication use and pain medication literacy in Taiwan

In this study, researchers evaluated the effectiveness of the implementation of a health promoting school (HPS) – community pharmacist partnership program in schools located in Taiwan. Previous studies have found that most adolescents are unaware of the correct use of certain medications, especially acetaminophen. This is concerning because in 1995, Taiwan developed a program that allowed patients to obtain a large assortment of drugs from health industries. Since 2012, the number of yearly outpatient visits in the country has increased twofold, and acetaminophen has become the primary cause of drug overdose and liver failure.

The HPS program was launched in Taiwan 2002, and expanded in 2009 to provide a more comprehensive medication education to children and adolescents in school. The total current number of schools enrolled in the program has increased since, and has the program has also been implemented in several other countries. This survey in particular included 89 intervention schools and 4,643 students. In the program, hospital and community pharmacists are invited to the schools to educate children about certain medication use. The primary teachings include how pain relievers work, how acetaminophen affects the liver, and the maximum dose of acetaminophen. The data analysis of the study shows that the students’ knowledge of correct medication use has increased since the implementation of the program.

This study is important because it demonstrates that current medication use is not well-understood in patents. It will be efficient to look into implementing education programs. Starting these programs in schools will give younger patients a head start on learning more about the pills that they are taking, and will allow them to prevent medication misuse.

 

Chang FC, Chi HY, Huang LJ, et al. Developing school-pharmacist partnerships to enhance correct medication use and pain medication literacy in Taiwan. J Am Pharm Assoc. 2003;44:595-602.

 

http://japha.org/article.aspx?articleid=2463334