Weekly versus basic smoking cessation support in primary care:: a randomised controlled trial
Weekly versus basic smoking cessation support in primary care:: a randomised controlled trial
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DOI：
10.1136/thx.2006.071837
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发表时间：
2007-10-01
期刊：
影响因子：
10
通讯作者：
Murphy, Mike
中科院分区：
文献类型：
--
作者：
Aveyard, Paul;Brown, Karen;Murphy, Mike
背景资料：有不足和相互矛盾的证据是否更密集的行为支持是更有效的比基本的行为支持戒烟和初级保健护士是否可以提供有效的behaviorssupport.Methods：一个随机对照试验进行了26英国的一般做法。925名每天吸烟≥ 10支的吸烟者被随机分配到基本或每周支持组。所有参与者都在戒烟前接受了治疗，在戒烟当天接受了电话治疗，并在初次预约后1周和4周接受了治疗（基本支持）。接受每周支持的参与者在初次预约后10天和3周时接受额外的电话呼叫，并在2周时接受额外的访问，以激励坚持尼古丁替代并重新尝试戒烟。所有参与者均给予15 mg/16 h尼古丁贴片。结果通过意向治疗分析来评估，在戒烟日后的第4、12、26和52周确认持续戒烟的百分比。在基础组和每周组的469名和456名参与者中，戒烟人数（%）和百分比差异为105（22.4%）vs 102（22.4%）、0.1%（95%CI-5.3%至5.5%）第4周，66（14.1%）vs 52（11.4%）、-2.6%（95% CI -6.9%至1.7%），12周时，50（10.7%）vs 40（8.8%），-1.9%（95% CI -5.7%至2.0%），26周和36周（7.7%）vs 30（6.6%），-1.1%（95% CI -4.4%至2.3%）。结论：达到的绝对戒烟率是单独使用尼古丁替代的预期戒烟率，这意味着基本或每周支持都无效。初级保健戒烟治疗应提供足够的支持药物治疗，以确保其正确使用，需要支持的人应转诊给专家。
Background: There is insufficient and conflicting evidence about whether more intensive behavioural support is more effective than basic behavioural support for smoking cessation and whether primary care nurses can deliver effective behavioural support.Methods: A randomised controlled trial was performed in 26 UK general practices. 925 smokers of >= 10 cigarettes per day were randomly allocated to basic or weekly support. All participants were seen before quitting, telephoned around quit day, and seen 1 and 4 weeks after the initial appointment (basic support). Participants receiving weekly support had an additional telephone call at 10 days and 3 weeks after the initial appointment and an additional visit at 2 weeks to motivate adherence to nicotine replacement and renew quit attempts. 15 mg/16 h nicotine patches were given to all participants. The outcome was assessed by intention to treat analyses of the percentage confirmed sustained abstinence at 4, 12, 26 and 52 weeks after quit day.Results: Of the 469 and 456 participants in the basic and weekly arms, the numbers (%) who quit and the percentage difference were 105 (22.4%) vs 102 (22.4%), 0.1% (95% CI -5.3% to 5.5%) at 4 weeks, 66 (14.1%) vs 52 (11.4%), -2.6% (95% CI -6.9% to 1.7%) at 12 weeks, 50 (10.7%) vs 40 (8.8%), -1.9% (95% CI -5.7% to 2.0%) at 26 weeks and 36 (7.7%) vs 30 (6.6%), -1.1% (95% CI -4.4% to 2.3%) at 52 weeks.Conclusions: The absolute quit rates achieved are those expected from nicotine replacement alone, implying that neither basic nor weekly support were effective. Primary care smoking cessation treatment should provide pharmacotherapy with sufficient support only to ensure it is used appropriately, and those in need of support should be referred to specialists.