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冠心病入院后戒烟干预的随机对照试验

Randomised controlled trial of smoking cessation intervention after admission for coronary heart disease.

作者信息

Quist-Paulsen Petter, Gallefoss Frode

机构信息

Medical Department, Soerlandet Sykehus Kristiansand, 4604 Kristiansand, Norway.

出版信息

BMJ. 2003 Nov 29;327(7426):1254-7. doi: 10.1136/bmj.327.7426.1254.

Abstract

OBJECTIVE

To determine whether a nurse led smoking cessation intervention affects smoking cessation rates in patients admitted for coronary heart disease.

DESIGN

Randomised controlled trial.

SETTING

Cardiac ward of a general hospital, Norway.

PARTICIPANTS

240 smokers aged under 76 years admitted for myocardial infarction, unstable angina, or cardiac bypass surgery. 118 were randomly assigned to the intervention and 122 to usual care (control group).

INTERVENTION

The intervention was based on a booklet and focused on fear arousal and prevention of relapses. The intervention was delivered by cardiac nurses without special training. The intervention was initiated in hospital, and the participants were contacted regularly for at least five months.

MAIN OUTCOME MEASURE

Smoking cessation rates at 12 months determined by self report and biochemical verification.

RESULTS

12 months after admission to hospital, 57% (n = 57/100) of patients in the intervention group and 37% (n = 44/118) in the control group had quit smoking (absolute risk reduction 20%, 95% confidence interval 6% to 33%). The number needed to treat to get one additional person who would quit was 5 (95% confidence interval, 3 to 16). Assuming all dropouts relapsed at 12 months, the smoking cessation rates were 50% in the intervention group and 37% in the control group (absolute risk reduction 13%, 0% to 26%).

CONCLUSION

A smoking cessation programme delivered by cardiac nurses without special training, significantly reduced smoking rates in patients 12 months after admission to hospital for coronary heart disease.

摘要

目的

确定由护士主导的戒烟干预措施是否会影响因冠心病入院患者的戒烟率。

设计

随机对照试验。

地点

挪威一家综合医院的心脏科病房。

参与者

240名年龄在76岁以下因心肌梗死、不稳定型心绞痛或心脏搭桥手术入院的吸烟者。118人被随机分配到干预组,122人接受常规护理(对照组)。

干预措施

干预基于一本手册,重点是唤起恐惧和预防复吸。干预由心脏科护士实施,无需特殊培训。干预在医院启动,参与者至少连续五个月定期接受联系。

主要观察指标

通过自我报告和生化验证确定12个月时的戒烟率。

结果

入院12个月后,干预组57%(n = 57/100)的患者和对照组37%(n = 44/118)的患者戒烟(绝对风险降低20%,95%置信区间6%至33%)。要使另外一人戒烟所需治疗的人数为5人(95%置信区间,3至16)。假设所有退出者在12个月时复吸,干预组的戒烟率为50%,对照组为37%(绝对风险降低13%,0%至26%)。

结论

由未经特殊培训的心脏科护士实施的戒烟计划,在因冠心病入院患者入院12个月后显著降低了吸烟率。

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