Adherence to Varenicline in the COMPASS Smoking Cessation Intervention Trial
Adherence to Varenicline in the COMPASS Smoking Cessation Intervention Trial
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DOI：
10.1093/ntr/ntr003
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发表时间：
2011-05-01
影响因子：
4.7
通讯作者：
Swan, Gary E.
中科院分区：
文献类型：
--
作者：
Catz, Sheryl L.;Jack, Lisa M.;Swan, Gary E.
简介：患者对戒烟药物的依从性会影响其有效性。重要的是要了解吸烟者实际服用处方药的程度，这如何影响戒烟结果，以及哪些因素可能影响adherence.Methods：从一个大型健康计划招募的吸烟者被随机接受不同模式的戒烟咨询与伐尼克兰（Swan，G. E、麦克卢尔，J. B.，杰克湖M.，Zbikowski，S. M.，Javitz，H.美国，Catz，S. L.，2010.行为咨询和伐尼克兰治疗戒烟。美国预防医学杂志，38，482-490）。1161名参与者在设定戒烟日期后，被邮寄了28天的瓦伦尼克林供应，并且能够免费从健康计划药房要求最多两次补充。药房填写记录，并完成电话调查，在基线，21天，12周，6个月后的目标quit dated.Results：良好的依从伐尼克兰（>= 80%的天）与一个两倍增加6个月的戒烟率相比，坚持较差（52%对25%）。吸烟者比不吸烟者更有可能提前停止伐尼克兰。有目的的不遵守与吸烟在12周，并预测在多变量分析的年龄，性别，遵守自我效能，和初始药物副作用severity.Conclusions：创新的方法，增加戒烟药物的依从性是必要的，特别是在戒烟过程的早期。依从性的简单指标，如服用戒烟药物的天数，可以也应该常规地纳入有效性试验，并报告以促进未来理解和减少不依从性的尝试。
Introduction: Patient adherence to smoking cessation medications can impact their effectiveness. It is important to understand the extent to which prescribed medications are actually taken by smokers, how this influences smoking cessation outcomes, and what factors may influence adherence.Methods: Smokers recruited from a large health plan were randomized to receive different modes of cessation counseling in combination with varenicline (Swan, G. E., McClure, J. B., Jack, L. M., Zbikowski, S. M., Javitz, H. S., Catz, S. L., et al. 2010.Behavioral counseling and varenicline treatment for smoking cessation. American Journal of Preventive Medicine, 38, 482-490). One thousand one hundred and sixty-one participants were mailed a 28-day varenicline supply when they set a quit date and were able to request up to two refills from the health plan pharmacy at no cost. Pharmacy fill records were obtained and telephone surveys completed at baseline, 21 days, 12 weeks, and 6 months post target quit date.Results: Good adherence to varenicline (>= 80% of days taken) was associated with a twofold increase in 6-month quit rates compared with poor adherence (52% vs. 25%). Smokers were more likely than nonsmokers to stop varenicline early. Purposeful nonadherence was associated with smoking at 12 weeks and was predicted in multivariate analyses by age, gender, adherence self-efficacy, and initial medication side effect severity.Conclusions: Innovative methods for increasing adherence to smoking cessation medications are needed, particularly early in the quit process. Simple metrics of adherence such as number of days cessation medication is taken can and should be routinely incorporated in effectiveness trials and reported to advance future attempts to understand and reduce nonadherence.