PHARMO Institute, Utrecht, The Netherlands.
J Med Econ. 2011;14(1):124-9. doi: 10.3111/13696998.2010.551165. Epub 2011 Jan 11.
Several pharmacological therapies are available to help smokers quit. The aim was to investigate the utilisation and effectiveness of smoking cessation drugs in daily practice in the Netherlands.
Subjects aged ≥18 years with a pharmacy prescription of varenicline, bupropion, nicotine replacement therapy (NRT) or nortriptyline between March 2007 and September 2008 were identified from the PHARMO data warehouse, which includes drug dispensing, hospitalisation and other data from approximately 2.5 million residents in the Netherlands. Using an encrypted methodology, corresponding non-person-identifiable dispensing IDs were linked to a web-based system for patient-reported data collection. Corresponding pharmacists asked the subjects to participate in the study and complete a web-based questionnaire on smoking history and cessation, including utilisation of (pharmaco) therapies.
Of 2,684 invited subjects, 698 responded (26%), of whom 612 were included in the analyses. Bupropion was the most frequently used smoking cessation drug (35% of patients), followed by varenicline (28%), bupropion + NRT (12%) and varenicline + NRT (9%). Overall, 51% of patients also reported behavioural therapy. A total of 53% of bupropion users, 51% of varenicline users, 42% of NRT users and 20-40% of patients using multiple drugs reported to not smoke at the time of questionnaire. Median (interquartile range) number of days between time of questionnaire and start date of last quit attempt ranged from 271 (104-432) for varenicline + bupropion to 356 (205-518) for bupropion. Mean duration of drug use ranged from 42 to 53 days among quitters and from 19 to 42 days among relapsers.
In this study up to 50% of patients who obtained smoking cessation drugs at the pharmacy stopped smoking. Better access to smoking cessation drugs as recommended in guidelines will help to further decrease smoking prevalence.
有多种药理学疗法可帮助吸烟者戒烟。本研究旨在调查在荷兰常规实践中使用戒烟药物的情况及其效果。
从 PHARMO 数据库中筛选出 2007 年 3 月至 2008 年 9 月间年龄≥18 岁、有维拉唑尼、安非他酮、尼古丁替代疗法（NRT）或去甲替林药房处方的受试者。PHARMO 数据库包含荷兰约 250 万居民的药物配给、住院和其他数据。通过使用加密方法，将相应的非个人身份识别配药 ID 与一个基于网络的患者报告数据收集系统相关联。相应的药剂师会邀请受试者参与研究，并完成一个关于吸烟史和戒烟情况的基于网络的问卷，包括（药物）疗法的使用情况。
在 2684 名受邀的受试者中，有 698 人（26%）做出了回应，其中 612 人纳入了分析。安非他酮是最常用的戒烟药物（占患者的 35%），其次是维拉唑尼（28%）、安非他酮+NRT（12%）和维拉唑尼+NRT（9%）。总体而言，51%的患者还报告了行为疗法。共有 53%的安非他酮使用者、51%的维拉唑尼使用者、42%的 NRT 使用者和 20%-40%的使用多种药物的患者在问卷调查时报告没有吸烟。问卷时间与最后一次戒烟尝试开始日期之间的中位数（四分位距）天数，从维拉唑尼+安非他酮的 271（104-432）天到安非他酮的 356（205-518）天不等。戒烟者中药物使用的平均持续时间从 42 天到 53 天不等，而复吸者的平均持续时间从 19 天到 42 天不等。
在这项研究中，多达 50%的在药房获得戒烟药物的患者成功戒烟。更好地获得指南推荐的戒烟药物将有助于进一步降低吸烟率。
