Tobacco Treatment Guideline Use and Predictors Among U.S. Physicians by Specialty.
Tobacco Treatment Guideline Use and Predictors Among U.S. Physicians by Specialty.
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DOI：
10.1016/j.amepre.2021.05.014
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发表时间：
2021-12
影响因子：
5.5
通讯作者：
Delnevo CD
中科院分区：
文献类型：
--
作者：
Schaer DA;Singh B;Steinberg MB;Delnevo CD
医生在烟草治疗中发挥着关键作用，是与吸烟者的频繁联系和值得信赖的信息来源。不幸的是，存在的障碍限制了医生实施循证干预措施。本研究探讨了美国医生中“5A”烟草治疗临床指南的实施和预测因素。2018年对来自6个专业（家庭医学，内科，妇产科，心脏科，肺病和肿瘤学）的1，058名美国医生进行了调查（回复率为51.8%）。调查领域包括：人口统计学、对指南的认识、烟草治疗实践（即，5A的），治疗的感知障碍，以及各种治疗的感知功效。多元逻辑回归分析了实施指南活动的预测因素。平均年龄为51.3岁，大多数为男性（64.4%）和非西班牙裔白色人（63.9%）。几乎所有的医生都报告询问患者是否吸烟（95.6%）并建议戒烟（94.8%），略少的医生评估戒烟准备（86.5%），只有少数医生协助戒烟计划（27.4%）或安排随访（18.6%）。只有18%的人报告在临床实践中使用美国公共卫生服务指南。时间相关因素是最常见的障碍（53.4%），患者因素（36.9%）和财务/资源因素（35.1%）引用较少。实施5A的预测因素包括医生对美国公共卫生服务指南的认识和利用，专业，以及1990年之前毕业的较小程度，不报告时间作为障碍，患者障碍，性别和更高的药物治疗效果。这项全国性调查强调，需要加强实施最新循证烟草治疗指南的所有方面，包括社区资源。
Physicians play a critical role in tobacco treatment, being a frequent link to smokers and a trusted source of information. Unfortunately, barriers exist that limit physicians’ implementation of evidence-based interventions. This study examines the implementation and predictors of the “5A’s” tobacco treatment clinical guidelines among U.S. physicians. A national sample of 1,058 U.S. physicians from 6 specialties (Family Medicine, Internal Medicine, Obstetrics and Gynecology, Cardiology, Pulmonology, and Oncology) were surveyed in 2018 (51.8% response rate). Survey domains included: demographics, awareness of guidelines, tobacco treatment practices (i.e., 5A’s), perceived barriers to treatment, and perceived efficacy of various treatments. Multiple logistic regression analyzed predictors of implementing guideline activities. Mean age was 51.3 years, with the majority male (64.4%) and non-Hispanic White (63.9%). Nearly all physicians reported asking patients if they smoke (95.6%) and advising to stop (94.8%), slightly fewer assessed readiness to quit (86.5%), and only a minority assisted with a quit plan (27.4%), or arranged follow-up (18.6%). Only 18% reported using the U.S. Public Health Service Guidelines in clinical practice. Time-related factors were the most common barriers (53.4%), with patient factors (36.9%) and financial/resource factors (35.1%) cited less frequently. Predictors of implementing aspects of the 5A’s included physician awareness and utilization of the U.S. Public Health Service guidelines, specialty, and to a smaller degree graduating prior to 1990, not reporting time as a barrier, patient barriers, sex, and higher perceived effectiveness of pharmacotherapy. This national survey highlights the need for increased implementation of all aspects of the latest guidelines for evidence-based tobacco treatments, including community-based resources.
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影响因子：
4.7
作者：
Conroy, MB;Majchrzak, NE;Rigotti, NA
通讯作者：
Rigotti, NA
DOI：
10.3205/000282
发表时间：
2020-01-01
期刊：
German medical science : GMS e-journal
影响因子：
--
作者：
Bauer, Anna;Brenner, Lorena;Bals, Robert
通讯作者：
Bals, Robert
DOI：
10.15585/mmwr.mm6946a4
发表时间：
2020-11-20
期刊：
MMWR. Morbidity and mortality weekly report
影响因子：
--
作者：
Cornelius ME;Wang TW;Jamal A;Loretan CG;Neff LJ
通讯作者：
Neff LJ
影响因子：
4.7
作者：
Tong, Elisa K.;Strouse, Richard;Schroeder, Steven A.
通讯作者：
Schroeder, Steven A.
影响因子：
2.3
作者：
Steinberg, Michael B.;Alvarez, Michelle S.;Cantor, Joel C.
通讯作者：
Cantor, Joel C.