Proactively Offered Text Messages and Mailed Nicotine Replacement Therapy for Smokers in Primary Care Practices: A Pilot Randomized Trial
Proactively Offered Text Messages and Mailed Nicotine Replacement Therapy for Smokers in Primary Care Practices: A Pilot Randomized Trial
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DOI：
10.1093/ntr/ntaa050
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发表时间：
2020-09-01
影响因子：
4.7
通讯作者：
Rigotti, Nancy A.
中科院分区：
文献类型：
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作者：
Kruse, Gina R.;Park, Elyse R.;Rigotti, Nancy A.
简介：积极主动，人口健康戒烟计划可以指导努力达到吸烟者以外的诊所，鼓励戒烟尝试和治疗use.Aims和方法：本研究旨在衡量试验的可行性和初步效果的积极干预提供短信（TM）和/或邮寄尼古丁替代疗法（NRT）的吸烟者在初级保健诊所。从2017年到2019年，我们进行了一项初步随机试验，比较了简短的电话建议（对照：BA），TM，2周邮寄NRT或两种干预措施（TM + NRT）。使用电子健康记录识别患者，并通过电话主动联系以评估对研究的兴趣。我们比较了退出尝试，治疗使用，并停止在干预武器与BA。结果：986例患者接触，153（16%）登记（平均年龄53岁，57%女性，76%白色，11%黑人，8%西班牙裔，52%由医疗补助）和144（94%）完成了12周的评估。平均而言，TM组的患者收到159条消息（99.4%发送，0.6%失败），发送19条消息，并在该计划中停留61天。在所有组中，大多数患者报告了戒烟尝试（BA 67% vs.TM 86% [p =.07]，NRT 81% [p =.18]，TM + NRT 79% [p =.21]）和NRT使用（BA 51% vs. NRT 83% [p =.007]，TM 65% [p =.25]，TM + NRT 76% [p =.03]）。报告的7天戒断的效应估计值分别为BA 10%和TM 26%（p =.09），NRT 28%（p =.06），TM + NRT 23%（p =.14）.结论：主动提供TM或邮寄尼古丁药物在初级保健吸烟者中是可行的，是促进戒烟尝试和短期戒烟的一种有前途的方法。积极的干预计划，以促进戒烟尝试以外的办公室访问登记的吸烟者在初级保健的做法是必要的。TM有可能吸引不打算戒烟的吸烟者或支持吸烟者进行有计划的戒烟尝试。这项试点研究证明了测试一种积极主动的治疗模式的可行性，包括TM和/或邮寄NRT，以促进戒烟尝试，治疗使用，并停止在初级保健中的非寻求治疗的吸烟者。
Introduction: Proactive, population health cessation programs can guide efforts to reach smokers outside of the clinic to encourage quit attempts and treatment use.Aims and Methods: This study aimed to measure trial feasibility and preliminary effects of a proactive intervention offering text messages (TM) and/or mailed nicotine replacement therapy (NRT) to smokers in primary care clinics. From 2017 to 2019 we performed a pilot randomized trial comparing brief telephone advice (control: BA), TM, 2 weeks of mailed NRT, or both interventions (TM + NRT). Patients were identified using electronic health records and contacted proactively by telephone to assess interest in the study. We compared quit attempts, treatment use, and cessation in the intervention arms with BA.Results: Of 986 patients contacted, 153 (16%) enrolled (mean age 53 years, 57% female, 76% white, 11% black, 8% Hispanic, 52% insured by Medicaid) and 144 (94%) completed the 12-week assessment. On average, patients in the TM arms received 159 messages (99.4% sent, 0.6% failed), sent 19 messages, and stayed in the program for 61 days. In all groups, a majority of patients reported quit attempts (BA 67% vs.TM 86% [p =.07], NRT 81% [p =.18],TM + NRT 79% [p =.21]) and NRT use (BA 51% vs. NRT 83% [p =.007],TM 65% [p =.25], TM + NRT 76% [p =.03]). Effect estimates for reported 7-day abstinence were BA 10% versus TM 26% (p =.09), NRT 28% (p =.06), and TM + NRT 23% (p =.14).Conclusions: Proactively offering TM or mailed nicotine medications was feasible among primary care smokers and a promising approach to promote quit attempts and short-term abstinence.Implications: Proactive intervention programs to promote quit attempts outside of office visits among smokers enrolled in primary care practices are needed. TM have potential to engage smokers not planning to quit or to support smokers to make a planned quit attempt.This pilot study demonstrates the feasibility of testing a proactive treatment model includingTM and/or mailed NRT to promote quit attempts, treatment use, and cessation among nontreatment-seeking smokers in primary care.