May Fiona C, Stocks Nigel, Barton Christopher
Discipline of General Practice, University of Adelaide, North Terrace, Adelaide, South Australia.
Eur J Cardiovasc Prev Rehabil. 2008 Dec;15(6):646-50. doi: 10.1097/HJR.0b013e3283101075.
Nicotine replacement therapy (NRT) has been shown to increase 12-month abstinence rates by as much as 50% when compared with placebo; however, NRT seems to be underutilized in the acute cardiac setting. This study explores the attitudes and beliefs of healthcare professionals regarding the use of NRT in acute cardiac inpatients, in an effort to identify and expose barriers that may impede the use of this drug in the acute cardiac care environment.
Framework analysis formed the methodological foundation of the study and provided the structure for analysis of data generated via qualitative, semistructured one-on-one interviews. A purposive sample of healthcare professionals practicing in the acute cardiac care setting informed the study.
Although health care professionals expressed strong views regarding the benefits of implementing NRT as a smoking cessation intervention, barriers were identified that hinder its use. Financial implications, lack of knowledge and safety issues all contributed to the institutional justification for rejecting hospital-based NRT as a secondary prevention intervention in the acute cardiac setting.
To proactively reduce the incidence of secondary cardiac events, education of healthcare professionals concerning tobacco addiction and available cessation treatments in the acute cardiac patient is paramount. Nicotine replacement products require further investigation to ascertain their safety and financial viability in the acute cardiac setting. Findings may support the implementation of NRT in the inpatient cardiac setting, and ultimately help curb the incidence of smoking-related mortality owing to secondary cardiac events.
与安慰剂相比，尼古丁替代疗法（NRT）已被证明可将12个月的戒烟率提高多达50%；然而，NRT在急性心脏疾病环境中似乎未得到充分利用。本研究探讨了医疗保健专业人员对在急性心脏疾病住院患者中使用NRT的态度和看法，以识别和揭示可能阻碍在急性心脏疾病护理环境中使用这种药物的障碍。
框架分析构成了该研究的方法基础，并为分析通过定性、半结构化一对一访谈产生的数据提供了结构。以在急性心脏疾病护理环境中执业的医疗保健专业人员为目的样本进行了该研究。
尽管医疗保健专业人员对实施NRT作为戒烟干预措施的益处表达了强烈的观点，但仍发现了阻碍其使用的障碍。财务问题、知识缺乏和安全问题都导致了机构拒绝在急性心脏疾病环境中将基于医院的NRT作为二级预防干预措施的理由。
为了积极降低继发性心脏事件的发生率，对医疗保健专业人员进行关于急性心脏疾病患者烟草成瘾和可用戒烟治疗的教育至关重要。尼古丁替代产品需要进一步研究，以确定其在急性心脏疾病环境中的安全性和财务可行性。研究结果可能支持在住院心脏疾病环境中实施NRT，并最终有助于遏制因继发性心脏事件导致的与吸烟相关的死亡率。
