A Randomized Clinical Trial of Nicotine Preloading for Smoking Cessation in People with Posttraumatic Stress Disorder.
A Randomized Clinical Trial of Nicotine Preloading for Smoking Cessation in People with Posttraumatic Stress Disorder.
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DOI：
10.1080/15504263.2018.1468947
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发表时间：
2018-07
影响因子：
2.2
通讯作者：
Beckham JC
中科院分区：
文献类型：
--
作者：
Dedert EA;Dennis PA;Calhoun PS;Dennis MF;Beckham JC
确定通过在戒烟日期前佩戴活性尼古丁贴片来加强标准戒烟治疗是否能提高创伤后应激障碍（PTSD）患者的戒烟率，并探索治疗反应机制，如减少吸烟渴望和缓解吸烟症状。81例吸烟的PTSD患者的双盲平行随机对照试验参与者是从退伍军人事务部门诊和社区传单招募的。参与者提供了PTSD症状的生态瞬时评估（EMA），吸烟戒断症状，以及在一周的随意吸烟期间吸烟前后的烟瘾，然后在戒烟日期前三周使用尼古丁贴片（n = 37）或安慰剂贴片（n = 44）。所有参与者在戒烟日期后接受标准的药物治疗和行为治疗。为了测试尼古丁贴片预加载在戒烟前阶段参与拟定治疗目标的有效性，我们使用多水平模型比较了预加载阶段吸烟后症状和渴望的变化与随意吸烟阶段报告的吸烟后变化。在戒烟后6周，以呼吸一氧化碳（CO）为生物标志的7天点戒烟率的主要结局方面，两种情况下的戒烟率无显著差异。在一个多变量多水平模型中，吸烟前后PTSD症状群、吸烟戒断症状和烟瘾的变化，在治疗阶段和病情之间存在显著的相互作用。相对于安慰剂条件下的参与者，尼古丁贴片条件下的参与者在吸烟后经历了PTSD再体验症状，吸烟戒断症状和香烟渴望的缓解减少。相对于安慰剂贴剂预载，尼古丁贴剂预载减少了吸烟的强化作用。然而，这两种情况下的低戒烟率表明尼古丁贴片预载对于PTSD患者戒烟来说并不是一种足够的强化治疗。临床试验NCT 00625131
To determine whether augmenting standard smoking cessation treatment by wearing an active nicotine patch before the smoking quit date improves rates of smoking cessation in individuals with posttraumatic stress disorder (PTSD), and to explore mechanisms of treatment response such as decreased cigarette craving and symptom relief from smoking. Double-blind parallel randomized controlled trial in 81 people with PTSD who smoked cigarettes. Participants were recruited from Veterans Affairs outpatient clinics and flyers in the community. Participants provided ecological momentary assessments (EMA) of PTSD symptoms, smoking withdrawal symptoms, and cravings before and after smoking a cigarette during one week of ad lib smoking, then three weeks of either a nicotine patch (n = 37) or placebo patch (n = 44) preceding the quit date. All participants received standard pharmacotherapy and behavioral treatment for smoking cessation after the quit date. To test the efficacy of nicotine patch preloading for engaging proposed treatment targets during the pre-quit phases, we used multilevel models to compare post-smoking changes in symptoms and cravings during the preloading phases to post-smoking changes reported during the ad lib smoking phase. There was no significant difference in quit rates across the two conditions on the primary outcome of 7-day point prevalence smoking abstinence bioverified with breath carbon monoxide (CO) at six weeks post-quit date. In a multivariable multilevel model pre- to post-cigarette changes in PTSD symptom clusters, smoking withdrawal symptoms, and cravings, there was a significant interaction between treatment phase and condition. Relative to participants in the placebo condition, participants in the nicotine patch condition experienced diminished relief from PTSD re-experiencing symptoms, smoking withdrawal symptoms, and cigarette craving after smoking a cigarette. Relative to placebo patch preloading, nicotine patch preloading diminished the reinforcing effects of smoking cigarettes. However, the low quit rates in both conditions suggest that nicotine patch preloading is not a sufficiently intensive treatment for achieving smoking cessation in people with PTSD. Clinical Trials NCT00625131
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影响因子：
3.3
作者：
Calhoun, Patrick S.;Levin, Holly F.;Beckham, Jean C.
通讯作者：
Beckham, Jean C.
影响因子：
2.5
作者：
Lindson-Hawley N;Coleman T;Docherty G;Hajek P;Lewis S;Lycett D;McEwen A;McRobbie H;Munafò MR;Parrott S;Aveyard P
通讯作者：
Aveyard P
影响因子：
120.7
作者：
Lasser, K;Boyd, JW;Bor, DH
通讯作者：
Bor, DH
影响因子：
4.4
作者：
Dennis, Paul A.;Kimbrel, Nathan A.;Calhoun, Patrick S.
通讯作者：
Calhoun, Patrick S.
影响因子：
4.7
作者：
Cropsey, Karen L.;Trent, Lindsay R.;Hendricks, Peter S.
通讯作者：
Hendricks, Peter S.