Long-Term Outcomes From Repeated Smoking Cessation Assistance in Routine Primary Care
Long-Term Outcomes From Repeated Smoking Cessation Assistance in Routine Primary Care
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DOI：
10.1177/0890117118761886
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发表时间：
2018-09-01
影响因子：
2.7
通讯作者：
Hazlehurst, Brian
中科院分区：
文献类型：
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作者：
Bailey, Steffani R.;Stevens, Victor J.;Hazlehurst, Brian
目的：测试反复临床戒烟支持与长期戒烟之间的关系。设计：使用电子健康记录的结构化和自由文本数据进行的回溯性观察性队列研究。背景：美国六个不同的健康系统。参与者：2007年18岁的吸烟者，在接下来的四年中每年有一次初级保健访问(N=33691)。测量：主要暴露是一个复合分类变量(包括戒烟药物、咨询或转介的文件)，分类患者接受戒烟帮助的就诊比例(=75%的就诊)。因变量为长期戒烟(LTQ；是/否)，定义为在表明非吸烟者或以前吸烟者的就诊后365天内没有迹象表明当前吸烟者。分析：混合影响Logistic回归分析调整了年龄、性别、种族和合并症，并用稳健的标准误差估计来解释现场内的相关性。结果：总体而言，20%的队列达到了长期戒烟状态。在接受任何帮助的就诊患者中，有75%的患者获得LTQ状态的几率几乎是那些有
Purpose: To test the association between repeated clinical smoking cessation support and long-term cessation.Design: Retrospective, observational cohort study using structured and free-text data from electronic health records.Setting: Six diverse health systems in the United States.Participants: Patients aged >= 18 years who were smokers in 2007 and had >= 1 primary care visit in each of the following 4 years (N = 33 691).Measures: Primary exposure was a composite categorical variable (comprised of documentation of smoking cessation medication, counseling, or referral) classifying the proportions of visits for which patients received any cessation assistance (= 75% of visits). The dependent variable was long-term quit (LTQ; yes/no), defined as no indication of being a current smoker for >= 365 days following a visit where nonsmoker or former smoker was indicated.Analysis: Mixed effects logistic regression analysis adjusted for age, sex, race, and comorbidities, with robust standard error estimation to account for within site correlation.Results: Overall, 20% of the cohort achieved LTQ status. Patients with >= 75% of visits with any assistance had almost 3 times the odds of achieving LTQ status compared to those with