Does it matter who you see to help you stop smoking? Short-term quit rates across specialist stop smoking practitioners in England
Does it matter who you see to help you stop smoking? Short-term quit rates across specialist stop smoking practitioners in England
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DOI：
10.1111/j.1360-0443.2012.03935.x
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发表时间：
2012-11-01
期刊：
影响因子：
6
通讯作者：
West, Robert
中科院分区：
文献类型：
--
作者：
Brose, Leonie S.;McEwen, Andy;West, Robert
在英格兰的国家卫生服务体系内建立了一个戒烟服务网络。这些服务提供行为支持和药物治疗。重要的是要确定戒烟率的变化程度归因于个体从业者之间的差异，以衡量通过培训和专业支持改善的范围。本分析的目的是检查短期戒烟率在多大程度上取决于医生提供的干预措施后，调整潜在的混杂变量。使用常规收集的数据设计观察性研究。英国31个NHS戒烟服务参与者数据来自46？237次一对一治疗（支持戒烟尝试）由专科医生提供。三水平logistic回归模型拟合一氧化碳（CO）验证的短期（4周）戒烟率。模型调整了年龄，性别，免除处方费用，每次治疗的药物和干预设置，每个医生的客户数量以及戒烟服务水平的经济贫困。二次分析包括（i）的吸烟指数（HSI）作为预测因子和（ii）4周戒烟率是否确认的CO。结果之间的差异个别专科医生解释了7.6%的变异CO验证戒烟率调整后的客户人口统计学，干预特征和医生和服务变量（P？
Aims A network of Stop Smoking Services has been set up within the National Health Service (NHS) in England. The services deliver a combination of behavioural support and medication. It is important to establish the degree of variability in quit rates attributable to differences between individual practitioners, to gauge the scope for improvement by training and professional support. The aim of the present analysis was to examine how far short-term quit rates depend on the practitioner delivering the intervention after adjusting for potential confounding variables. Design Observational study using routinely collected data. Setting Thirty-one NHS Stop Smoking Services in England. Participants Data from 46?237 one-to-one treatment episodes (supported quit attempts) delivered by specialist practitioners. Measurements Three-level logistic regression models were fitted for carbon monoxide (CO)-validated short-term (4-week) quit rates. Models adjusted for age, gender, exemption from prescription charges, medication and intervention setting for each treatment episode, number of clients for each practitioner and economic deprivation at the level of the Stop Smoking Service. Secondary analyses included (i) the Heaviness-of-Smoking Index (HSI) as predictor and (ii) 4-week quit rates whether or not confirmed by CO. Findings Differences between individual specialist practitioners explained 7.6% of the variance in CO-verified quit rates after adjusting for client demographics, intervention characteristics and practitioner and service variables (P?