Communication Between US Physicians and Patients Regarding Electronic Cigarette Use.
Communication Between US Physicians and Patients Regarding Electronic Cigarette Use.
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DOI：
10.1001/jamanetworkopen.2022.6692
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发表时间：
2022-04-01
影响因子：
13.8
通讯作者：
Steinberg, Michael B.
中科院分区：
文献类型：
--
作者：
Delnevo, Cristine D.;Jeong, Michelle;Teotia, Arjun;Manderski, Michelle M. Bover;Singh, Binu;Hrywna, Mary;Wackowski, Olivia A.;Steinberg, Michael B.
医生如何与患者就电子烟进行沟通？在这项对2058名受访者的横断面调查中，被患者问及电子烟的医生，赞同减少危害的观点，或者曾经吸烟的医生更有可能向患者推荐电子烟。在假设的临床场景中，医生更有可能向以前戒烟失败的老年重度吸烟者推荐电子烟，并向以前没有戒烟治疗的年轻轻度吸烟者推荐使用药物治疗。这项调查研究的结果表明，在某些基于风险的情况下，医生建议使用电子烟戒烟或减少危害，例如治疗患有烟草相关疾病的患者。医生在患者戒烟中起着主要作用，但他们关于电子烟的沟通还没有得到很好的理解。评估关于电子烟的医患沟通。在2018年和2019年进行了全国横断面调查。参与者是通过邮件邀请的；调查是在线完成的。受访者是来自家庭医学、内科、妇产科、心脏病学、肺病和肿瘤学的2058名委员会认证医生。数据分析时间为2021年8月至9月。在两种假设的临床情景中应用医师人口统计学特征、烟草使用、医学专业和减少危害的信念（即并非所有烟草制品的危害都相同）。医生自我报告的电子烟沟通（被患者询问电子烟并向患者推荐电子烟）和2种临床场景下的假设电子烟沟通。2058名医生中，平均（SD）年龄为51.6岁（10.5岁），男性1173名（58.5%）。超过60%的医生认为所有烟草制品的危害是一样的。总体而言，69.8%的医生报告曾被患者问及电子烟（过去30天内为35.9%），21.7%的医生报告曾向患者推荐电子烟（过去30天内为9.8%）。肺科医生（校正优势比[aOR]， 2.14, 95% CI, 1.10-4.16）和心脏病专家（aOR, 2.04, 95% CI, 1.03-4.05）以及执行美国公共卫生服务临床实践指南的医生（aOR, 1.77, 95% CI, 1.12-2.80）向患者推荐电子烟的几率更大。支持减少危害观点（aOR, 3.04, 95% CI, 2.15-4.31）和曾经吸过烟（aOR, 1.98, 95% CI, 1.27-3.08）的医生更倾向于推荐电子烟。报告被问及电子烟的医生推荐电子烟的几率更大（aOR, 16.60; 95% CI, 10.33-26.68）。在临床情况下，医生总体上更有可能向多次戒烟失败的老年重度吸烟者推荐电子烟戒烟（49.3%;95% CI, 47.1%-51.4%），而没有戒烟治疗的年轻轻度吸烟者（15.2%;95% CI, 13.6%-16.7%） （P < .001）。在这项对医生的调查研究中，研究结果表明，医生可能会建议一些在某些情况下吸烟的患者改用电子烟，可能是为了戒烟。认为所有烟草产品都同样有害的信念与较低的电子烟推荐率有关。随着电子烟对戒烟效果的证据基础越来越多，有必要对医生进行有关电子烟功效的教育。本调查研究评估了在美国对医生进行的两波大型全国调查中，医生和患者之间关于电子烟使用的沟通情况。
How do physicians communicate with their patients about e-cigarettes? In this cross-sectional survey of 2058 respondents, physicians who were asked about e-cigarettes by their patients, endorsed a harm-reduction perspective, or had ever smoked were more likely to recommend e-cigarettes to patients. In hypothetical clinical scenarios, physicians were more likely to recommend e-cigarettes for an older heavy smoker with prior unsuccessful quit attempts and use of pharmacotherapy for a younger light smoker with no prior cessation treatments. Results of this survey study suggest that physicians are recommending e-cigarettes for cessation or harm reduction under certain risk-based circumstances, such as treating patients with tobacco-related disease. Physicians play a primary role in patient smoking cessation, yet their communication regarding e-cigarettes is not well understood. To assess physician-patient communication regarding e-cigarettes. A national cross-sectional survey in 2018 and 2019 was conducted. Participants were invited by mail; surveys were completed online. Respondents were 2058 board-certified physicians from family medicine, internal medicine, obstetrics and gynecology, cardiology, pulmonary, and oncology. Data were analyzed from August to September 2021. Physician demographic characteristics, tobacco use, medical specialty, and harm-reduction beliefs (ie, not all tobacco products are equally harmful) applied within 2 hypothetical clinical scenarios. Physicians’ self-reported e-cigarette communication (being asked about e-cigarettes by patients and recommending e-cigarettes to patients) and hypothetical e-cigarette communication in 2 clinical scenarios. Among 2058 physicians, the mean (SD) age was 51.6 (10.5) years, and 1173 (58.5%) were male. More than 60% of physicians believed all tobacco products to be equally harmful. Overall, 69.8% of physicians reported ever being asked about e-cigarettes by their patients (35.9% in the past 30 days), and 21.7% reported ever recommending e-cigarettes to a patient (9.8% in the past 30 days). Pulmonologists (adjusted odds ratio [aOR], 2.14, 95% CI, 1.10-4.16) and cardiologists (aOR, 2.04; 95% CI, 1.03-4.05), as well as physicians who implemented the US Public Health Service Clinical Practice Guidelines (aOR, 1.77; 95% CI, 1.12-2.80), had greater odds of recommending e-cigarettes to patients. Physicians who endorsed a harm-reduction perspective (aOR, 3.04, 95% CI, 2.15-4.31) and had ever smoked cigarettes (aOR, 1.98; 95% CI, 1.27-3.08) were significantly more likely to recommend e-cigarettes. Physicians who reported being asked about e-cigarettes had greater odds of recommending e-cigarettes (aOR, 16.60; 95% CI, 10.33-26.68). In clinical scenarios, physicians were overall more likely to recommend e-cigarettes for cessation to an older heavy smoker with multiple unsuccessful quit attempts (49.3%; 95% CI, 47.1%-51.4%) than a younger light smoker with no prior cessation treatments (15.2%; 95% CI, 13.6%-16.7%) (P < .001). In this survey study of physicians, findings suggest that physicians may recommend switching to e-cigarettes for some patients who smoke cigarettes under certain circumstances, presumably for cessation. The belief that all tobacco products are equally harmful was associated with lower rates of recommending e-cigarettes. As the evidence base grows for e-cigarette efficacy for smoking cessation, there is need for physician education regarding e-cigarette efficacy. This survey study assesses communications between physicians and patients about e-cigarette use in 2 waves of a large national survey of physicians in the US.
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影响因子：
9.8
作者：
England LJ;Anderson BL;Tong VT;Mahoney J;Coleman-Cowger VH;Melstrom P;Schulkin J
通讯作者：
Schulkin J
影响因子：
3.7
作者：
Kandra KL;Ranney LM;Lee JG;Goldstein AO
通讯作者：
Goldstein AO
DOI：
10.1080/20009666.2017.1343076
发表时间：
2017-07
影响因子：
1
作者：
Kanchustambham V;Saladi S;Rodrigues J;Fernandes H;Patolia S;Santosh S
通讯作者：
Santosh S
影响因子：
5.5
作者：
Giovenco, Daniel P.;Lewis, M. Jane;Delnevo, Cristine D.
通讯作者：
Delnevo, Cristine D.
DOI：
10.3122/jabfm.2017.06.170183
发表时间：
2017-11-01
影响因子：
2.9
作者：
Northrup, Thomas F.;Klawans, Michelle R.;Stotts, Angela L.
通讯作者：
Stotts, Angela L.