Benefits of telephone care over primary care for smoking cessation - A randomized trial
Benefits of telephone care over primary care for smoking cessation - A randomized trial
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DOI：
10.1001/archinte.166.5.536
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发表时间：
2006-03-13
影响因子：
--
通讯作者：
Joseph, AM
中科院分区：
文献类型：
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作者：
An, LC;Zhu, SH;Joseph, AM
背景：简短的临床干预和电话咨询都是戒烟的有效辅助手段。然而，电话治疗的潜在好处超过常规的临床医生干预之前还没有被检查。本研究的目的是确定是否电话保健增加戒烟相比，简短的临床干预的一部分，常规healthcare.Methods：这2组，前瞻性，随机对照试验纳入了837名每日吸烟者从5退伍军人事务部医疗中心在上中西部。电话护理组（n = 417）接受行为咨询，并根据临床指征邮寄戒烟药物。标准护理组（n = 420）接受干预作为常规卫生保健的一部分。主要结局是入组后12个月自我报告的6个月禁欲持续时间。次要结果是在3个月和12个月时的7天点戒烟率、参与咨询计划和使用戒烟药物。结果：使用意向治疗程序，我们发现在12个月随访时，电话护理组的6个月戒烟率为13.0%，标准护理组为4.1（比值比[OR]，3.50; 95%置信区间[CI]，1.99-6.15）。3个月时电话治疗组的7天时点戒烟率为39.6%，标准治疗组为10.1%（OR，5.84; 95%CI，4.02-8.50）。与标准护理相比，电话护理增加了咨询计划的参与率（97.1% vs 24.0%; OR，96.22; 95% CI，52.57-176.11）和使用戒烟药物结论：与常规的健康护理人员干预相比，电话护理增加了行为和药物帮助的使用，导致更高的戒烟率。
Background: Brief clinician intervention and telephone counseling are both effective aids for smoking cessation. However, the potential benefit of telephone care above and beyond routine clinician intervention has not been examined previously. The objective of this study is to determine if telephone care increases smoking cessation compared with brief clinician intervention as part of routine health care.Methods: This 2-group, prospective, randomized controlled trial enrolled 837 daily smokers from 5 Veterans Affairs medical centers in the upper Midwest. The telephone care group (n = 417) received behavioral counseling with mailing of smoking cessation medications as clinically indicated. The standard care group (n = 420) received intervention as part of routine health care. The primary outcome was self-reported 6-month duration of abstinence 12 months after enrollment. Secondary outcomes were 7-day point prevalence abstinence at 3 and 12 months, participation in counseling programs, and use of smoking cessation medications.Results: Using intention-to-treat procedures, we found that the rate of 6-month abstinence at the 12-month follow-up was 13.0% in the telephone care group and 4.1% in the standard care group (odds ratio [OR], 3.50; 95% confidence interval [CI], 1.99-6.15). The rate of 7-day point prevalence abstinence at 3 months was 39.6% in the telephone care group and 10.1% in the standard care group ( OR, 5.84; 95% CI, 4.02-8.50). Telephone care compared with standard care increased the rates of participation in counseling programs (97.1% vs 24.0%; OR, 96.22; 95% CI, 52.57-176.11) and use of smoking cessation medications (89.6% vs 52.3%; OR, 7.85; 95% CI, 5.34-11.53).Conclusion: Telephone care increases the use of behavioral and pharmacologic assistance and leads to higher smoking cessation rates compared with routine health care provider intervention.