Cox Lisa Sanderson, Cupertino Ana-Paula, Mussulman Laura M, Nazir Niaman, Greiner K Allen, Mahnken Jonathan D, Ahluwalia Jasjit S, Ellerbeck Edward F
University of Kansas School of Medicine, Department of Preventive Medicine and Public Health, MS 1008, 3901 Rainbow Blvd, Kansas City, KS 66160, USA.
Prev Med. 2008 Aug;47(2):200-5. doi: 10.1016/j.ypmed.2008.04.013. Epub 2008 May 3.
To describe the design, implementation, baseline data, and feasibility of establishing a disease management program for smoking cessation in rural primary care.
The study is a randomized clinical trial evaluating a disease management program for smoking cessation. The intervention combined pharmacotherapy, telephone counseling, and physician feedback, and repeated intervention over two years. The program began in 2004 and was implemented in 50 primary care clinics across the State of Kansas.
Of eligible patients, 73% were interested in study participation. 750 enrolled participants were predominantly Caucasian, female, employed, and averaged 47.2 years of age (SD=13.1). In addition to smoking, 427 (57%) had at least one additional major risk factor for cardiovascular disease (diabetes, hypertension, high cholesterol, heart disease or stroke). Participants smoked on average 23.7 (SD=10.4) cigarettes per day, were contemplating (61%) or preparing to quit (30%), were highly motivated and confident of their ability to quit smoking, and reported seeing their physicians multiple times in the past twelve months (Median=3.50; Mean=5.48; SD=6.58).
Initial findings demonstrate the willingness of patients to enroll in a two-year disease management program to address nicotine dependence, even among patients not ready to make a quit attempt. These findings support the feasibility of identifying and enrolling rural smokers within the primary care setting.
描述在农村基层医疗中建立戒烟疾病管理项目的设计、实施、基线数据及可行性。
本研究为一项评估戒烟疾病管理项目的随机临床试验。干预措施包括药物治疗、电话咨询和医生反馈,并在两年内重复干预。该项目于2004年启动,在堪萨斯州的50家基层医疗诊所实施。
符合条件的患者中,73%对参与研究感兴趣。750名登记参与者主要为白人、女性、有工作,平均年龄47.2岁(标准差=13.1)。除吸烟外,427名(57%)至少还有一项心血管疾病的主要额外危险因素(糖尿病、高血压、高胆固醇、心脏病或中风)。参与者平均每天吸烟23.7支(标准差=10.4),正在考虑戒烟(61%)或准备戒烟(30%),积极性很高且对自己戒烟的能力有信心,并且报告在过去十二个月内多次就诊(中位数=3.50;平均数=5.48;标准差=6.58)。
初步研究结果表明,即使在尚未准备好尝试戒烟的患者中,他们也愿意参加为期两年的疾病管理项目来解决尼古丁依赖问题。这些结果支持了在基层医疗环境中识别并招募农村吸烟者的可行性。