The Agency for Health Care Policy and Research Smoking Cessation Clinical Practice Guideline
The Agency for Health Care Policy and Research Smoking Cessation Clinical Practice Guideline
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DOI：
10.1001/jama.1996.03530400058039
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发表时间：
1996-04-24
影响因子：
120.7
通讯作者：
Baker, TB
中科院分区：
文献类型：
--
作者：
Fiore, MC;Wetter, DW;Baker, TB
客观。-总结戒烟临床实践指南，为3组专业人士提供建议：初级保健临床医生，戒烟专家，医疗保健管理人员，保险公司和采购人员。由美国卫生保健政策和研究机构选出的科学家，临床医生，消费者和方法学家组成的独立小组。1975年至1994年间发表的英语同行评审文献，涉及烟草依赖、尼古丁成瘾和临床实践的评估和治疗。在2年内举行了四次小组会议，以评估荟萃分析和其他结果，综合结果，并提出建议。该指南经过反复审查和修订。该小组的建议针对3个受众，对初级保健临床医生的主要建议是使用办公室范围内的系统来识别吸烟者，对每一个吸烟者进行戒烟或动机干预，提供尼古丁替代品，除非在特殊情况下，并在戒烟后安排随访联系，对戒烟专家的主要建议是使用多次个人或团体咨询会议，每次持续至少20分钟，对卫生保健管理人员、保险公司和购买者的主要建议是，在所有诊所使用烟草使用者识别系统，通过工作人员教育和培训、专门的工作人员、医院政策的变化以及为烟草依赖治疗提供报销来支持戒烟治疗。
Objective.-To summarize the Smoking Cessation Clinical Practice Guideline that provides recommendations for 3 groups of professionals: primary care clinicians, smoking cessation specialists, and health care administrators, insurers, and purchasers.Participants.-An independent panel of scientists, clinicians, consumers, and methodologists selected by the US Agency for Health Care Policy and Research.Evidence.-English-language, peer-reviewed literature published between 1975 and 1994 that addresses the assessment and treatment of tobacco dependence, nicotine addiction, and clinical practice.Consensus Process.-Four panel meetings were held over 2 years to evaluate meta-analytic and other results, to synthesize the results, and to develop recommendations. The Guideline was repeatedly reviewed and revised.Conclusions.-The panel recommendations address 3 audiences, Major recommendations for primary care clinicians are to use officewide systems to identify smokers, treat every smoker with a cessation or motivational intervention, offer nicotine replacement except in special circumstances, and schedule follow-up contact to occur after cessation, Major recommendations to smoking cessation specialists are to use multiple individual or group counseling sessions lasting at least 20 minutes each with sessions spanning multiple weeks, offer nicotine replacement, and provide problem-solving and social support counseling, Major recommendations for health care administrators, insurers, and purchasers are that tobacco-user identification systems be used in all clinics and that smoking cessation treatment be supported through staff education and training, dedicated staff, changes in hospital policies, and the provision of reimbursement for tobacco-dependence treatment.