Effects of post-discharge counseling and medication utilization on short and long-term smoking cessation among hospitalized patients.
Effects of post-discharge counseling and medication utilization on short and long-term smoking cessation among hospitalized patients.
复制标题
出院后咨询和药物使用对住院患者短期和长期戒烟的影响。
DOI：
10.1016/j.pmedr.2019.100937
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发表时间：
2019
影响因子：
2.8
通讯作者：
Faseru,Babalola
中科院分区：
文献类型：
--
作者：
Liebmann,EdwardP;Richter,KimberP;Scheuermann,Taneisha;Faseru,Babalola
许多研究已经测试了多组分出院后戒烟干预措施对出院后戒烟的影响，其中许多是有效的。然而，关于不同干预成分对短期或长期戒烟的相对功效知之甚少。本研究是对2011年至2014年在堪萨斯两家大医院进行的住院吸烟者随机对照试验的二次分析（n= 984）。所有研究参与者都提供了出院后戒烟服务。建议在床边烟草治疗期间进行药物治疗。研究结局为随机化后1个月时自我报告的戒烟和6个月时经生化证实的戒烟。在出院后期间，69%的参与者完成了至少一个戒烟热线电话，28%的参与者报告使用了戒烟药物治疗。在控制了住院吸烟者戒烟的已知预测因素后，出院后完成的戒烟热线电话总数和出院后使用戒烟药物治疗的数量都可预测1个月时的戒烟。在考虑了1个月时戒烟和戒烟的预测因素后，出院后戒烟热线电话总数与6个月时戒烟相关（OR[95% CI] = 1.23 [1.12，1.35]，p< 0.001），而出院后戒烟药物治疗的使用则无关。结果表明，无论是在戒烟服务和使用药物治疗独立促进戒烟超出已知的临床特征与戒烟的影响。从长远来看，参与戒烟服务的效果持续存在，而药物治疗的效果则会减弱。为了优化结果，未来的研究应探讨增加药物利用率和促进持续咨询参与的方法，以维持出院后治疗的效果。
Numerous studies have tested the effect of multicomponent post-discharge smoking cessation interventions on post-discharge smoking cessation, and many are effective. However, little is known regarding the relative efficacy of the different intervention components on short or long-term cessation. The present study is a secondary analysis (n= 984) of a randomized controlled trial for hospitalized smokers that took place at two large hospitals in Kansas from 2011 to 2014. All study participants were offered post-discharge quitline services. Pharmacotherapy was recommended during bedside tobacco treatment. The study outcomes were self-reported cessation at 1-month and biochemically verified cessation at 6-months post-randomization. During the post-discharge period, 69% of participants completed at least one quitline call and 28% of participants reported using cessation pharmacotherapy. After controlling for known predictors of cessation among hospitalized smokers, both the number of total quitline calls completed post-discharge and use of cessation pharmacotherapy post-discharge were predictive of cessation at 1-month. After accounting for predictors of cessation and quitting at 1-month, total post-discharge quitline calls was associated with cessation at 6-months (OR[95% CI] = 1.23 [1.12, 1.35],p< 0.001) while post-discharge cessation pharmacotherapy use was not. The results suggest that both engagement in quitline services and use pharmacotherapy independently facilitate cessation beyond the influence of known clinical characteristics associated with cessation. Over the longer term, the effect of engaging in quitline services persists while the effect of pharmacotherapy diminishes. To optimize outcomes, future research should investigate methods to increase utilization of medications and promote sustained counseling engagement in order to sustain the effects of treatment during the post-discharge period.