Long-term Outcomes of a Cell Phone-Delivered Intervention for Smokers LivingWith HIV/AIDS
Long-term Outcomes of a Cell Phone-Delivered Intervention for Smokers LivingWith HIV/AIDS
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DOI：
10.1093/cid/cit349
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发表时间：
2013-08-15
影响因子：
11.8
通讯作者：
Vidrine, Damon J.
中科院分区：
文献类型：
--
作者：
Gritz, Ellen R.;Danysh, Heather E.;Vidrine, Damon J.
背景。与一般人群相比，人类免疫缺陷病毒(HIV)/艾滋病（PLWHA）感染者的吸烟率要高得多。此外，艾滋病感染者特别容易受到吸烟对健康的不利影响。我们的主要目的是设计和测试针对plwha的戒烟干预12个月的疗效。参与者从一个多种族和经济弱势患者群体的城市HIV诊所招募。参与者通过常规护理（UC）或通过手机干预（CPI）提供的咨询接受戒烟治疗。在3、6和12个月时，使用逻辑回归和广义线性混合模型评估7天的点流行性戒断。我们将474名hiv阳性吸烟者随机分为UC组和CPI组。当评估整体治疗效果（从3个月、6个月和12个月的随访中得出的7天戒断结果）时，CPI组的参与者表现出戒断的可能性是UC组的2.41倍（P = 0.049）。治疗效果在随访3个月时最强（优势比= 4.3,P < 0.001），但在随访6个月和12个月时减弱（优势比P < 0.05）。与常规护理方法相比，手机戒烟治疗对戒断率有积极影响。未来的研究应侧重于长期维持治疗效果的策略。
Background. People living with human immunodeficiency virus (HIV)/AIDS (PLWHA) have a substantially higher prevalence of cigarette smoking compared to the general population. In addition, PLWHA are particularly susceptible to the adverse health effects of smoking. Our primary objective was to design and test the efficacy over 12 months of a smoking cessation intervention targeting PLWHA.Methods. Participants were enrolled from an urban HIV clinic with a multiethnic and economically disadvantaged patient population. Participants received smoking cessation treatment either through usual care (UC) or counseling delivered by a cell phone intervention (CPI). The 7-day point prevalence abstinence was evaluated at 3, 6, and 12 months using logistic regression and generalized linear mixed models.Results. We randomized 474 HIV-positive smokers to either the UC or CPI group. When evaluating the overall treatment effect (7-day abstinence outcomes from 3-, 6-, and 12-month follow-ups), participants in the CPI group were 2.41 times (P = .049) more likely to demonstrate abstinence compared to the UC group. The treatment effect was strongest at the 3-month follow-up (odds ratio = 4.3, P < .001), but diminished at 6 and 12 months (P > .05).Conclusions. Cell phone-delivered smoking cessation treatment has a positive impact on abstinence rates compared to a usual care approach. Future research should focus on strategies for sustaining the treatment effect in the long term.