Saba M, Diep J, Saini B, Dhippayom T
Faculty of Pharmacy, The University of Sydney, Sydney, NSW, Australia.
J Clin Pharm Ther. 2014 Jun;39(3):240-7. doi: 10.1111/jcpt.12131. Epub 2014 Jan 13.
With the emerging and promising role of healthcare professionals in implementing smoking cessation services, community pharmacists, in particular, can play a pivotal role. The aim of this meta-analysis is to evaluate the effectiveness of smoking cessation interventions delivered by community pharmacists in assisting smokers to quit.
PubMed, EMBASE, Scopus, International Pharmaceutical Abstracts and ISI Web of Knowledge were searched from inception to May 2013. Original research articles were selected for review, if they addressed the effectiveness of pharmacy-based interventions in smokers vs. a control group and reported smoking abstinence rates as an outcome. Obtained studies were assessed for methodological quality using the Cochrane Effective Practice and Organization of Care Group risk of bias tool. The primary outcome of measure was smoking abstinence based on the 'most rigorous criterion'. Pooled relative risks (RR) with 95% confidence interval (CI) were estimated using the Dersimonian and Laird random-effects models. Corresponding subgroup met-analysis was performed.
Of the 1168 articles extracted, five studies (three randomized controlled trials and two controlled before-after studies) met the inclusion criteria, involving a total of 1426 smokers. Pharmacist interventions showed better abstinence rates as compared with controls (RR 2·21, 95% CI 1·49-3·29). Compared with the control group, the RR (95% CI) in the intervention group was 3·21 (1·81-5·72) for clinically validated abstinence and 1·66 (1·08-2·54) for self-reported abstinence. In the intervention group, the RR for short-term and long-term abstinence was 2·48 (1·15-5·31) and 2·40 (1·37-4·23), respectively.
Pharmacist-led interventions can significantly impact abstinence rates in smokers. Health policymakers should direct incentives for community pharmacists to provide such services.
随着医疗保健专业人员在实施戒烟服务中发挥着越来越重要且充满前景的作用，尤其是社区药剂师，能够起到关键作用。本荟萃分析的目的是评估社区药剂师提供的戒烟干预措施在帮助吸烟者戒烟方面的有效性。
检索了从创刊至2013年5月的PubMed、EMBASE、Scopus、国际药学文摘和ISI网络知识数据库。如果原始研究文章探讨了基于药房的干预措施对吸烟者与对照组的有效性，并将戒烟率作为结果进行报告，则选择这些文章进行综述。使用Cochrane有效实践和护理组织小组偏倚风险工具评估纳入研究的方法学质量。测量的主要结果是基于“最严格标准”的戒烟情况。使用DerSimonian和Laird随机效应模型估计合并相对风险（RR）及95%置信区间（CI）。进行了相应的亚组荟萃分析。
在提取的1168篇文章中，五项研究（三项随机对照试验和两项前后对照研究）符合纳入标准，共涉及1426名吸烟者。与对照组相比，药剂师干预显示出更好的戒烟率（RR 2.21，95% CI 1.49 - 3.29）。与对照组相比，干预组临床验证戒烟的RR（95% CI）为3.21（1.81 - 5.72），自我报告戒烟的RR为1.66（1.08 - 2.54）。在干预组中，短期和长期戒烟的RR分别为2.48（1.15 - 5.31）和2.40（1.37 - 4.23）。
由药剂师主导的干预措施可显著影响吸烟者的戒烟率。卫生政策制定者应激励社区药剂师提供此类服务。
