Steinberg Michael B, Nanavati Kaushal, Delnevo Cristine D, Abatemarco Diane J
University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, 125 Paterson Street, New Brunswick, NJ, 08903, USA.
Addict Behav. 2007 Dec;32(12):3045-53. doi: 10.1016/j.addbeh.2007.08.001. Epub 2007 Aug 24.
Physicians play an important role in smoking cessation, especially discussing medications. This study evaluates physician characteristics associated with higher rates of discussion of smoking cessation medications. 336 primary-care physicians in New Jersey completed a cross-sectional, self-administered, mail survey including physician demographics, practice type, previous training and confidence in treating tobacco dependence, awareness of guidelines, and perceived effectiveness of treatments. Two-thirds of respondents felt confident in using cessation medications despite only 24% having previous training and only 13% having read or implemented practice guidelines. After controlling for other variables, female physicians were more likely to discuss medications compared with males (adjusted odds ratio(AOR) 2.2; 95% confidence interval(CI) 1.0-4.6); physicians who were confident were more likely to discuss (AOR 3.0;95% CI 1.7-5.3); and physicians in private practices (solo, group, or multispecialty) were more likely to discuss than those employed by an agency (hospital, state, or federal) (AOR 3.1;95% CI 1.4-6.8). Most physicians in this sample reported routinely discussing cessation medications, with female physicians, those feeling confident, and those in private practices doing so more frequently. Considering limited resources and opportunities to access physicians, interventions to increase discussion of effective cessation treatments could be targeted to specific physician groups.
医生在戒烟过程中发挥着重要作用,尤其是在讨论药物治疗方面。本研究评估了与更高频率讨论戒烟药物相关的医生特征。新泽西州的336名初级保健医生完成了一项横断面、自我管理的邮件调查,调查内容包括医生的人口统计学信息、执业类型、以前接受的培训以及治疗烟草依赖的信心、对指南的知晓情况和对治疗效果的认知。三分之二的受访者表示对使用戒烟药物有信心,尽管只有24%的人接受过以前的培训,只有13%的人阅读或实施过实践指南。在控制了其他变量后,与男性相比,女性医生更有可能讨论药物治疗(调整后的优势比[AOR]为2.2;95%置信区间[CI]为1.0 - 4.6);有信心的医生更有可能进行讨论(AOR为3.0;95% CI为1.7 - 5.3);私人执业医生(单人、团体或多专科)比机构(医院、州或联邦)雇佣的医生更有可能进行讨论(AOR为3.1;95% CI为1.4 - 6.8)。该样本中的大多数医生报告说经常讨论戒烟药物,女性医生、有信心的医生以及私人执业医生讨论得更频繁。考虑到接触医生的资源和机会有限,增加对有效戒烟治疗讨论的干预措施可以针对特定的医生群体。