The effects of prescribing varenicline on two-year health outcomes: an observational cohort study using electronic medical records.
The effects of prescribing varenicline on two-year health outcomes: an observational cohort study using electronic medical records.
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DOI：
10.1111/add.14146
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发表时间：
2018-06
期刊：
影响因子：
--
通讯作者：
Thomas KH
中科院分区：
文献类型：
--
作者：
Davies NM;Taylor GMJ;Taylor AE;Jones T;Martin RM;Munafò MR;Windmeijer F;Thomas KH
目的：研究吸烟者在治疗后的4年内，与尼古丁替代疗法(NRT)相比，服用varenicline的吸烟者是否有较低的严重健康不良风险。电子病历的观察性队列研究。从临床实践研究数据链接中抽样的总共370个英国普通实践。2006年9月1日至2014年3月31日期间，共有126名18岁及以上的 718患者获得戒烟处方。我们的主要结果是第一张处方后两年内的全因死亡率，这一点由国家统计局的相关数据显示。我们的次要结果是原因特定死亡率、所有原因、特定原因住院、心肌梗死或慢性阻塞性肺疾病(COPD)的初级保健诊断、体重指数和首次处方后两年内初级保健的就诊率。多变量调整回归和倾向得分匹配回归估计风险差异和95%可信区间。我们使用工具变量分析来克服残差混杂。在基线时，服用varenicline的患者在几乎所有特征上都比那些服用NRT的患者更健康，这突出了残留混杂的可能性。我们的工具变量分析结果发现，服用varenicline的人在2年内的死亡风险与服用NRT的人相似[每100名接受治疗的患者的风险差=0.67，95%可信区间(CI)=-0.11至1.46]，而且全原因住院率、心肌梗死和COPD的初级保健诊断事件的发生率相似。开了varenicline处方的人随后去初级保健的频率减少了。在英国，与开尼古丁替代疗法的吸烟者相比，在英国初级保健中开出varenicline处方的吸烟者在接下来的两年里死亡、住院或经历心肌梗死或慢性阻塞性肺病的可能性似乎并没有降低，但他们体重增加了更多，去初级保健的频率也更低。
To investigate whether smokers prescribed varenicline had lower risks of serious ill‐health during the 4 years following treatment compared with those prescribed nicotine replacement therapy (NRT). Observational cohort study of electronic medical records. A total of 370 UK general practices sampled from the Clinical Practice Research Datalink. A total of 126 718 patients aged 18 and over who were issued smoking cessation prescriptions between 1 September 2006 and 31 March 2014. Our primary outcome was all‐cause mortality within 2 years of first prescription as indicated by linked Office of National Statistics data. Our secondary outcomes were cause‐specific mortality, all‐cause, cause‐specific hospitalization, primary care diagnosis of myocardial infarction or chronic obstructive pulmonary disease (COPD), body mass index and attendance rate to primary care within 2 years of first prescription. Risk differences and 95% confidence intervals were estimated by multivariable adjusted regression and propensity score matched regression. We used instrumental variable analysis to overcome residual confounding. People prescribed varenicline were healthier at baseline than those prescribed NRT in almost all characteristics, highlighting the potential for residual confounding. Our instrumental variable analysis results found that people prescribed varenicline had a similar risk of mortality at 2 years [risk difference per 100 patients treated = 0.67, 95% confidence interval (CI) = ‐0.11 to 1.46)] to those prescribed NRT, and there were similar rates of all‐cause hospitalization, incident primary‐care diagnoses of myocardial infarction and COPD. People prescribed varenicline subsequently attended primary care less frequently. Smokers prescribed varenicline in primary care in the United Kingdom do not appear to be less likely to die, be hospitalized or experience a myocardial infarction or chronic obstructive pulmonary disease during the following 2 years compared with smokers prescribed nicotine replacement therapy, but they gain more weight and attend primary care less frequently.
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影响因子：
39.2
作者：
Yeh HC;Duncan BB;Schmidt MI;Wang NY;Brancati FL
通讯作者：
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DOI：
10.1080/01621459.2012.734171
发表时间：
2012-12-01
影响因子：
3.7
作者：
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通讯作者：
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影响因子：
5.4
作者：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
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影响因子：
1.4
作者：
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