Baker Amanda L, Richmond Robyn, Kay-Lambkin Frances J, Filia Sacha L, Castle David, Williams Jill M, Lewin Terry J, Clark Vanessa, Callister Robin, Weaver Natasha
Priority Research Centre for Translational Neuroscience and Mental Health, University of Newcastle, Callaghan, Australia;
School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia;
Nicotine Tob Res. 2015 Aug;17(8):946-54. doi: 10.1093/ntr/ntv039. Epub 2015 Mar 5.
People with severe mental disorders typically experience a range of health problems; consequently, interventions addressing multiple health behaviors may provide an efficient way to tackle this major public health issue. This two-arm randomized controlled trial among people with psychotic disorders examined the efficacy of nicotine replacement therapy (NRT) plus either a face-to-face or predominantly telephone delivered intervention for smoking cessation and cardiovascular disease (CVD) risk reduction.
Following baseline assessment and completion of a common, individually delivered 90-minute face-to-face intervention, participants (n = 235) were randomized to receive NRT plus: (1) a "Healthy Lifestyles" intervention for smoking cessation and CVD risk behaviors or (2) a predominantly telephone-based intervention (designed to control for NRT provision, session frequency, and other monitoring activities). Research assistants blind to treatment allocation performed assessments at 15 weeks (mid-intervention) and 12 months after baseline.
There were no significant differences between intervention conditions in CVD risk or smoking outcomes at 15 weeks or 12 months, with improvements in both conditions (eg, 12 months: 6.4% confirmed point prevalence abstinence rate; 17% experiencing a 50% or greater smoking reduction; mean reduction of 8.6 cigarettes per day; mean improvement in functioning of 9.8 points).
The health disparity experienced by people with psychotic disorders is high. Face-to-face Healthy Lifestyle interventions appear to be feasible and somewhat effective. However, given the accessibility of telephone delivered interventions, potentially combined with lower cost, further studies are needed to evaluate telephone delivered smoking cessation and lifestyle interventions for people with psychotic disorders.
患有严重精神障碍的人通常会经历一系列健康问题；因此，针对多种健康行为的干预措施可能是解决这一重大公共卫生问题的有效途径。这项针对患有精神疾病的人群进行的双臂随机对照试验，研究了尼古丁替代疗法（NRT）加上面对面或主要通过电话进行的干预措施对戒烟和降低心血管疾病（CVD）风险的效果。
在基线评估并完成一次通用的、针对个体的90分钟面对面干预后，参与者（n = 235）被随机分配接受NRT加上：（1）一项针对戒烟和CVD风险行为的“健康生活方式”干预，或（2）一项主要基于电话的干预（旨在控制NRT的提供、疗程频率和其他监测活动）。对治疗分配不知情的研究助理在基线后15周（干预中期）和12个月进行评估。
在15周或12个月时，干预组在CVD风险或吸烟结果方面没有显著差异，两种情况均有改善（例如，12个月时：确认的点患病率戒烟率为6.4%；17%的人吸烟减少50%或更多；平均每天减少8.6支香烟；功能平均改善9.8分）。
患有精神疾病的人所经历的健康差距很大。面对面的健康生活方式干预似乎是可行的且有一定效果。然而，考虑到电话干预的可及性，可能还具有较低成本，需要进一步研究来评估针对患有精神疾病的人的电话戒烟和生活方式干预。
