Assessing Trends in Tobacco Cessation in Diverse Patient Populations.
Assessing Trends in Tobacco Cessation in Diverse Patient Populations.
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评估不同患者群体的戒烟趋势。
DOI：
10.1093/ntr/ntv092
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发表时间：
2016
期刊：
影响因子：
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通讯作者：
Hazlehurst,BrianL
中科院分区：
文献类型：
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作者：
Stevens,VictorJ;Solberg,LeifI;Bailey,SteffaniR;Kurtz,StephenE;McBurnie,MaryAnn;Priest,ElisaL;Puro,JonE;Williams,RebeccaJ;Fortmann,StephenP;Hazlehurst,BrianL
引言本研究使用电子病历数据检查了6个不同医疗保健机构的普通患者人群中4年内烟草使用的变化。（N= 34393）包括2007年确定为吸烟者的所有18岁或以上患者，然后在接下来的4年中每年至少有一次初级保健就诊。结果在2007年之后的4年中，该患者队列的平均初级保健就诊次数为13次，38.6%的患者至少戒烟一次。在第四年随访结束时，15.4%的人戒烟1年或以上。65岁以上的吸烟者更有可能成为长期戒烟者（OR= 1.32，95% CI = [1.16，1.49]），或诊断为癌症（1.26 [1.12，1.41]）、心血管疾病（1.22 [1.09，1.37]）、哮喘（1.15 [1.06，1.25]）或糖尿病（1.17 [1.09，1.27]）。与成为长期戒烟者的可能性较低相关的特征是女性（0.90 [0.84，0.95]），黑人（0.84 [0.75，0.94]）和那些被确定为非西班牙裔（0.50 [0.43，0.59]）。这项研究表明，随着时间的推移，使用电子病历监测患者吸烟状况的实用性。类似的方法可以用来评估任何卫生保健组织的烟草使用情况，以评估环境和组织计划的影响。
IntroductionThis study examined change in tobacco use over 4 years among the general population of patients in six diverse health care organizations using electronic medical record data.MethodsThe study cohort (N= 34 393) included all patients age 18 years or older who were identified as smokers in 2007, and who then had at least one primary care visit in each of the following 4 years.ResultsIn the 4 years following 2007, this patient cohort had a median of 13 primary care visits, and 38.6% of the patients quit smoking at least once. At the end of the fourth follow-up year, 15.4% had stopped smoking for 1 year or more. Smokers were more likely to become long-term quitters if they were 65 or older (OR= 1.32, 95% CI = [1.16, 1.49]), or had a diagnoses of cancer (1.26 [1.12, 1.41]), cardiovascular disease (1.22 [1.09, 1.37]), asthma (1.15 [1.06, 1.25]), or diabetes (1.17 [1.09, 1.27]). Characteristics associated with lower likelihood of becoming a long-term quitter were female gender (0.90 [0.84, 0.95]), black race (0.84 [0.75, 0.94]) and those identified as non-Hispanic (0.50 [0.43, 0.59]).ConclusionsAmong smokers who regularly used these care systems, one in seven had achieved long-term cessation after 4 years. This study shows the practicality of using electronic medical records for monitoring patient smoking status over time. Similar methods could be used to assess tobacco use in any health care organization to evaluate the impact of environmental and organizational programs.