提高药剂师辅助戒烟的效果：一项关于戒烟率中参与者和药房特定差异的研究。

Improving the effectiveness of pharmacist-assisted tobacco cessation: a study of participant- and pharmacy-specific differences in quit rates.

作者信息

Shen Xian, Bachyrycz Amy, Anderson Joe R, Tinker Dale, Raisch Dennis W

机构信息

University of Maryland Baltimore School of Pharmacy, Baltimore, MD, USA.

University of New Mexico College of Pharmacy, Albuquerque, NM, USA Walgreens, Albuquerque, NM, USA.

出版信息

Ann Pharmacother. 2015 Mar;49(3):303-10. doi: 10.1177/1060028014563949. Epub 2014 Dec 19.

DOI:10.1177/1060028014563949

PMID:25527101

Abstract

BACKGROUND

The New Mexico Pharmaceutical Care Foundation provided a pharmacist-assisted tobacco cessation program from 2004 to 2010. In evaluating the program, discrepant 6-month quit rates were observed between pharmacies.

OBJECTIVE

To identify participant- and pharmacy-specific factors associated with improved quit rates.

METHODS

To supplement data regarding participant characteristics and quit rates, semistructured interviews of 7 participating pharmacists were conducted. Multivariate logistic regression quantified associations between successful abstinence at 6 months and participant characteristics and pharmacy-specific factors.

RESULTS

Quit rates by pharmacy ranged from 1.1% to 59.4% (mean = 19.1%). There were 1235 participants enrolled at 7 pharmacies, and because of missing participant data, 883 were included in the quantitative analysis. Three pharmacy-specific characteristics distinguished 6-month success rates: number and duration of follow-ups and format of counseling sessions. Participants followed up at least 3 times were more likely to quit at 6 months than those contacted once or twice (odds ratio [OR] =4.9; 95% CI = 1.6-15.0). Compared with follow-ups of <15 minutes, longer durations of follow-ups were associated with higher success rates: 15 to 30 minutes, OR = 7.2, 95% CI = 3.7-14.3); >30 minutes, OR = 10.0, 95% CI = 3.5-28.9. Participants who attended group sessions were more likely to quit at 6 months than those who attended individual sessions: OR = 8.2; 95% CI = 2.8-23.9. Most pharmacists (88%) noted that participants' high or low commitment to quit was associated with success or failure, respectively. Several pharmacists (43%) noted difficulties with follow-up associated with participants' relapse. Time constraints were an obstacle noted by 70% of pharmacists.

CONCLUSIONS

Pharmacy-specific factors, including counseling format and program intensity, affected success.

摘要

背景

新墨西哥州药学护理基金会在2004年至2010年期间提供了一项由药剂师协助的戒烟计划。在评估该计划时，各药房之间观察到6个月戒烟率存在差异。

目的

确定与提高戒烟率相关的参与者及药房特定因素。

方法

为补充有关参与者特征和戒烟率的数据，对7名参与的药剂师进行了半结构化访谈。多变量逻辑回归量化了6个月成功戒烟与参与者特征及药房特定因素之间的关联。

结果

各药房的戒烟率从1.1%到59.4%不等（平均为19.1%）。7家药房共有1235名参与者，由于缺少参与者数据，883名被纳入定量分析。三个药房特定特征区分了6个月的成功率：随访次数和时长以及咨询会议形式。接受至少3次随访的参与者在6个月时戒烟的可能性高于接受1次或2次随访的参与者（优势比[OR]=4.9；95%置信区间[CI]=1.6-15.0）。与随访时间<15分钟相比，较长的随访时间与较高的成功率相关：15至30分钟，OR=7.2，95%CI=3.7-14.3；>30分钟，OR=10.0，95%CI=3.5-28.9。参加小组会议的参与者在6个月时戒烟的可能性高于参加个人会议的参与者：OR=8.2；95%CI=2.8-23.9。大多数药剂师（88%）指出，参与者戒烟的高承诺或低承诺分别与成功或失败相关。几位药剂师（43%）指出与参与者复发相关的随访困难。70%的药剂师指出时间限制是一个障碍。