Aimer Pip, Stamp Lisa K, Stebbings Simon, Cameron Vicky, Kirby Sandra, Croft Suzanne, Treharne Gareth J
Department of Medicine, University of Otago, Christchurch, New Zealand.
Department of Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
Musculoskeletal Care. 2016 Mar;14(1):2-14. doi: 10.1002/msc.1106. Epub 2015 May 18.
Smoking is associated with an increased risk of comorbidities in rheumatoid arthritis (RA) and may reduce the efficacy of anti-rheumatic therapies. Smoking cessation is therefore an important goal in RA. Our previous qualitative research identified five RA-related barriers to smoking cessation: lack of support; limited knowledge of the relationship between smoking and RA; uncontrolled pain; inability to exercise; and using smoking as a coping strategy. The aim of this article is to describe the process of developing a smoking cessation intervention for RA patients based on these themes.
A comprehensive review of the literature on smoking cessation was undertaken. A tailored smoking cessation programme was designed to address each RA-specific barrier. A meeting was convened with key staff of Arthritis New Zealand to develop a consensus on feasible design to deliver a smoking cessation programme based on existing best practice and smoking cessation resources, and tailored within existing Arthritis New Zealand service delivery frameworks.
A three-month intervention was designed to be delivered by trained arthritis educators, with the following key components: nicotine replacement therapy for eight weeks; a telephone or face-to-face interview with each patient to determine their individual specific RA-related barriers to smoking cessation; and individualized education and support activities which addressed these barriers. The intervention also included three follow-up telephone calls; a support website; and 12 weekly smoking cessation advice emails.
A RA-specific smoking cessation invention was developed, matching support to specific issues within each patient's experience. A pilot study is in progress to evaluate the programme's efficacy. Copyright © 2015 John Wiley & Sons, Ltd.
吸烟与类风湿关节炎（RA）患者共病风险增加相关，且可能降低抗风湿治疗的疗效。因此，戒烟是类风湿关节炎治疗的一个重要目标。我们之前的定性研究确定了类风湿关节炎患者戒烟的五个相关障碍：缺乏支持；对吸烟与类风湿关节炎之间关系的认识有限；疼痛控制不佳；无法锻炼；以及将吸烟作为一种应对策略。本文旨在描述基于这些主题为类风湿关节炎患者制定戒烟干预措施的过程。
对戒烟相关文献进行了全面综述。设计了一个量身定制的戒烟计划，以应对每个与类风湿关节炎相关的障碍。与新西兰关节炎协会的关键工作人员召开了一次会议，就基于现有最佳实践和戒烟资源、并在新西兰关节炎协会现有服务提供框架内量身定制的戒烟计划的可行设计达成共识。
设计了一个为期三个月的干预措施，由经过培训的关节炎教育工作者实施，包括以下关键组成部分：为期八周的尼古丁替代疗法；与每位患者进行电话或面对面访谈，以确定他们个人与类风湿关节炎相关的戒烟障碍；以及针对这些障碍的个性化教育和支持活动。该干预措施还包括三次随访电话；一个支持网站；以及每周发送一次的12封戒烟建议电子邮件。
开发了一种针对类风湿关节炎患者的戒烟干预措施，根据每位患者的具体情况提供相应支持。一项试点研究正在进行中，以评估该计划的疗效。版权所有© 2015约翰威立父子有限公司。
