Sherman Scott E, Joseph Anne M, Yano Elizabeth M, Simon Barbara F, Arikian Nancy, Rubenstein Lisa V, Parkerton Patricia, Mittman Brian S
Veterans Administration Health Services Research and Development, Center of Excellence for the Study of Healthcare Provider Behavior, Veterans Administration Greater Los Angeles Healthcare System, Sepulveda, CA 91343, USA.
Mil Med. 2006 Jan;171(1):80-7. doi: 10.7205/milmed.171.1.80.
National smoking cessation guidelines include recommended strategies for providers and health care organizations, but they offer little guidance on how to structure care. We conducted a cross-sectional survey at 40 Veterans Health Administration facilities, to describe the structure of smoking cessation care, to assess adherence to national guidelines, and to assess facilities' preferred approach to providing smoking cessation treatment. We categorized sites as those using a primary care approach (most smokers treated by the primary care provider) versus a specialty approach (medication restricted to smoking cessation clinics, to which most patients were referred). Nearly all sites reported systematic screening for smoking and counseling of smokers, usually by both nursing staff members and the primary care provider. Most sites used a specialty approach, restricting medication access to smokers attending a cessation program. Future research should evaluate whether this approach provides adequate access and responsiveness to patient preferences for the full population of smokers in primary care.
国家戒烟指南为医疗服务提供者和医疗机构提供了推荐策略，但在如何构建护理方面几乎没有提供指导。我们在40个退伍军人健康管理局设施进行了一项横断面调查，以描述戒烟护理的结构，评估对国家指南的遵守情况，并评估各设施提供戒烟治疗的首选方法。我们将这些场所分为采用初级保健方法的场所（大多数吸烟者由初级保健提供者治疗）和专科方法的场所（药物仅限于戒烟诊所，大多数患者被转诊到该诊所）。几乎所有场所都报告了对吸烟的系统筛查和对吸烟者的咨询，通常由护理人员和初级保健提供者共同进行。大多数场所采用专科方法，将药物获取限制在参加戒烟计划的吸烟者。未来的研究应评估这种方法是否能为初级保健中全体吸烟者人群提供足够的获取途径并满足患者的偏好。
