评估药剂师提供的戒烟计划有效性的随机试验。
Randomized trial assessing the effectiveness of a pharmacist-delivered program for smoking cessation.
作者信息
Dent Larry A, Harris Kari Jo, Noonan Curtis W
机构信息
Department of Pharmacy Practice, Skaggs School of Pharmacy, The University of Montana, Missoula, MT 59812, USA.
出版信息
Ann Pharmacother. 2009 Feb;43(2):194-201. doi: 10.1345/aph.1L556. Epub 2009 Feb 3.
BACKGROUND
As trained and accessible healthcare professionals, pharmacists are in an ideal position to provide tobacco cessation interventions. Of the 15 studies identified in the literature assessing the effectiveness of tobacco cessation interventions delivered by pharmacists, this is the first randomized controlled trial conducted in the US of a pharmacist-delivered program for smoking cessation using biochemical confirmation.
OBJECTIVE
To assess the effectiveness on smoking cessation of a face-to-face group program conducted by the pharmacist team compared with a brief standard care session delivered by a pharmacist over the telephone.
METHODS
An open-label, prospective, randomized, controlled trial was conducted at a Veterans Health Administration, community-based outpatient clinic in the Rocky Mountain region. Participants were randomly assigned to receive a 3-session face-to-face group program conducted by the pharmacist team or one 5- to 10-minute standard care session delivered by the pharmacist team over the telephone. Participants in both groups were offered either immediate-release bupropion or nicotine patch at no cost. The primary outcome of self-reported abstinence was biochemically confirmed by urinary cotinine at 6 months after the quit date.
RESULTS
One hundred one smokers were randomized from October 3, 2005, to March 30, 2007, with the last 6-month follow-up survey completed on November 6, 2007. Analysis of data was completed in December 2007. Using intent-to-treat procedures, confirmed abstinence rates at the end of 6 months were 28% in the pharmacist-delivered face-to-face treatment group and 11.8% in the standard care telephone session control group (p < 0.041).
CONCLUSIONS
This study demonstrates that pharmacists are effective providers of tobacco cessation interventions. Greater utilization of pharmacists in tobacco cessation efforts could have a significant impact on smoking rates, prevention of tobacco-related diseases, and overall improvement in public health across the US.
背景
作为训练有素且易于接触到的医疗保健专业人员,药剂师处于提供戒烟干预措施的理想位置。在文献中确定的15项评估药剂师提供的戒烟干预措施有效性的研究中,这是美国首次针对使用生化确认的药剂师提供的戒烟计划进行的随机对照试验。
目的
评估药剂师团队开展的面对面小组计划与药剂师通过电话提供的简短标准护理课程相比,对戒烟的有效性。
方法
在落基山地区的退伍军人健康管理局社区门诊诊所进行了一项开放标签、前瞻性、随机对照试验。参与者被随机分配接受药剂师团队开展的为期3节的面对面小组计划,或药剂师团队通过电话提供的一次5至10分钟的标准护理课程。两组参与者均免费获得速释安非他酮或尼古丁贴片。自我报告的戒烟主要结局在戒烟日期后6个月通过尿可替宁进行生化确认。
结果
2005年10月3日至2007年3月30日,101名吸烟者被随机分组,最后一次6个月随访调查于2007年11月6日完成。数据分析于2007年12月完成。采用意向性分析方法,在6个月末,药剂师提供的面对面治疗组的确认戒烟率为28%,标准护理电话课程对照组为11.8%(p<0.041)。
结论
本研究表明,药剂师是有效的戒烟干预措施提供者。在戒烟工作中更多地利用药剂师可能会对美国的吸烟率、预防烟草相关疾病以及整体公共卫生改善产生重大影响。