Primary Healthcare Centre Canet de Mar, Catalan Health Institute, Canet de Mar (Barcelona), Spain.
BMC Fam Pract. 2011 Jun 28;12:61. doi: 10.1186/1471-2296-12-61.
Undiagnosed airflow limitation is common in the general population and is associated with impaired health and functional status. Smoking is the most important risk factor for this condition. Although primary care practitioners see most adult smokers, few currently have spirometers or regularly order spirometry tests in these patients. Brief medical advice has shown to be effective in modifying smoking habits in a large number of smokers but only a small proportion remain abstinent after one year. The aim of this study is to evaluate the effectiveness of regular reporting of spirometric results combined with a smoking cessation advice by a primary care physician on smoking quit rate in adult smokers.
METHODS/DESIGN: Intervention study with a randomized two arms in 5 primary care centres. A total of 485 smokers over the age of 18 years consulting their primary care physician will be recruited.On the selection visit all participants will undergo a spirometry, peak expiratory flow rate, test of smoking dependence, test of motivation for giving up smoking and a questionnaire on socio-demographic data. Thereafter an appointment will be made to give the participants brief structured advice to give up smoking combined with a detailed discussion on the results of the spirometry. After this, the patients will be randomised and given appointment for follow up visits at 3, 6, 12 and 24 months. Both arms will receive brief structured advice and a detailed discussion of the spirometry results at visit 0. The control group will only be given brief structured advice about giving up smoking on the follow up. Cessation of smoking will be tested with the carbon monoxide test.
Early identification of functional pulmonary abnormalities in asymptomatic patients or in those with little respiratory symptomatology may provide "ideal educational opportunities". These opportunities may increase the success of efforts to give up smoking and may improve the opportunities of other preventive actions to minimise patient risk. Comparing adult smokers in the intervention group with those in the control group, a minimum improvement expected with respect to the rates of smoking cessation would represent a large number of avoided morbimortality.
ClinicalTrials.gov: NCT01296295.
未诊断的气流受限在普通人群中很常见，与健康和功能状态受损有关。吸烟是这种情况的最重要危险因素。尽管初级保健医生看到的大多数成年吸烟者都没有肺活量计，也没有定期为这些患者开具肺活量计检查。简短的医疗建议已被证明在改变大量吸烟者的吸烟习惯方面非常有效，但只有一小部分人在一年后仍保持不吸烟。这项研究的目的是评估定期报告肺活量计结果并结合初级保健医生提供戒烟建议对成年吸烟者戒烟率的影响。
方法/设计：在 5 个初级保健中心进行随机双盲干预研究。将招募 485 名年龄在 18 岁以上的吸烟者参加。在选择就诊时，所有参与者都将进行肺活量计检查、呼气峰流速测定、吸烟依赖测试、戒烟动机测试和社会人口统计学数据问卷。之后，将安排参与者接受简短的结构化戒烟建议，并详细讨论肺活量计结果。之后，患者将被随机分组，并在 3、6、12 和 24 个月进行随访。两组在就诊 0 时都将接受简短的结构化建议和详细的肺活量计结果讨论。对照组仅在随访时接受简短的结构化戒烟建议。使用一氧化碳测试来检测吸烟的停止情况。
早期识别无症状患者或仅有轻微呼吸道症状患者的功能性肺部异常可能提供“理想的教育机会”。这些机会可能会增加戒烟努力的成功率，并可能为其他预防措施提供机会，以最大程度地降低患者风险。与对照组的成年吸烟者相比，干预组预期在戒烟率方面的最低改善将代表大量避免的发病率和死亡率。
ClinicalTrials.gov：NCT01296295。
