Quit in general practice: a cluster randomized trial of enhanced in-practice support for smoking cessation
Quit in general practice: a cluster randomized trial of enhanced in-practice support for smoking cessation
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DOI：
10.1093/fampra/cmu089
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发表时间：
2015-04-01
期刊：
影响因子：
2.2
通讯作者：
Borland, Ron
中科院分区：
文献类型：
--
作者：
Zwar, Nicholas A.;Richmond, Robyn L.;Borland, Ron
目标。评估主要由执业护士（PN）提供的量身定制的戒烟支持的吸收和有效性，并将其与其他形式的戒烟支持方法进行比较。三组随机对照试验在悉尼和墨尔本的101个全科诊所进行，涉及2390名吸烟者。采用PN干预的戒烟组与戒烟热线转诊组和常规护理对照组进行比较。建议所有组接受戒烟药物治疗。在随访3个月和12个月时通过自我报告评估结果。还报告了干预措施的采用情况。三组在基线时相似。12个月随访率为82%。3个月时各组持续戒断率和点流行戒断率分别为：PN干预13.1%和16.3%；戒烟热线转介10.8%和14.2%；普通全科医生护理11.4%和15.0%。12个月时，PN干预率分别为5.4%和17.1%；戒烟热线转介分别为4.4%和18.8%；普通全科医生护理2.9%和16.4%。在PN干预组中，只有43%的患者去看护士。多水平回归分析显示干预总体上没有影响，但接受部分或完全PN支持的患者更有可能报告持续戒断[部分支持优势比（or） 2.27；完全支持[5.34]。结果显示各组在意向治疗分析上无差异。那些接受更多强化PN干预的患者更有可能戒烟。这可能与患者动机或PN引导的戒烟支持的效果有关。
Objectives. To evaluate the uptake and effectiveness of tailored smoking cessation support, provided primarily by the practice nurse (PN), and compare this to other forms of cessation support.Methods. Three arm cluster randomized controlled trial conducted in 101 general practices in Sydney and Melbourne involving 2390 smokers. The Quit with PN intervention was compared to Quitline referral and a usual care control group. Smoking cessation pharmacotherapy was recommended to all groups. Outcomes were assessed by self-report at 3- and 12-month follow-up. Uptake of the interventions is also reported.Results. The three groups were similar at baseline. Follow-up at 12 months was 82%. The sustained and point prevalence abstinence rates, respectively, at 3 months by group were: PN intervention 13.1% and 16.3%; Quitline referral 10.8% and 14.2%; Usual GP care 11.4% and 15.0%. At 12 months, the rates were: PN intervention 5.4% and 17.1%; Quitline referral 4.4% and 18.8%; Usual GP care 2.9% and 16.4%. Only 43% of patients in the PN intervention group attended to see the nurse. Multilevel regression analysis showed no effect of the intervention overall, but patients who received partial or complete PN support were more likely to report sustained abstinence [partial support odds ratio (OR) 2.27; complete support OR 5.34].Conclusion. The results show no difference by group on intention to treat analysis. Those patients who received more intensive PN intervention were more likely to quit. This may have been related to patient motivation or an effect of PN led cessation support.