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伐尼克兰在现实环境中戒烟的两年治疗效果

Two-Year Therapeutic Effectiveness of Varenicline for Smoking Cessation in a Real World Setting.

作者信息

Pascual Francisco Pastor, Fontoba Ferrándiz Julio, Gil Sanchez María Carmen, Ponce Lorenzo Francisco, Botella Estrella Carlos

机构信息

a Unidad de Conductas Adictivas de Alcoy , Alcoy , Spain.

b Public Health Center , Alcoy , Spain.

出版信息

Subst Use Misuse. 2016 Jan 28;51(2):131-40. doi: 10.3109/10826084.2015.1018547. Epub 2016 Feb 1.

Abstract

BACKGROUND

Varenicline is an effective smoking cessation therapy in clinical trials. However, its effectiveness might vary in a real world setting and its long term effectiveness (2-year) has not been reported yet.

OBJECTIVE

The objective was ascertaining the effectiveness of varenicline in the treatment of tobacco consumption in Primary Care settings.

METHODS

Observational, multicenter, retrospective study using medical records of smokers followed for 24 months. Sociodemographic characteristics, comorbidity, type of treatment (varenicline with or without group therapy), and smoking characteristics (Fageström and Richmond tests, starting age, number of cigarettes, cessation attempts, and initial CO-oximeter measurements) were evaluated.

RESULTS

773 smokers treated with varenicline (72.4%) or varenicline combined with group therapy (27.6%) were included. Mean age was 43.6 years [51.7% male (n = 400)]. Continuous abstinence rate at 24 months was 44.4%, with no significant gender or age differences. Median cessation time was 398 days (95%CI: 376-421). A clear association was detected between the probability of remaining abstinent at 24 months and participation in group therapy (OR: 1.877, 95%CI: 1.362-2.589), as well as treatment adherence (compliance >80%) (OR: 6.556, 95%CI: 5.870-7.242), but not with co-financing of treatment (observed in 77% of patients). For every day that varenicline was taken, abstinence increased by an average of 6.6 days.

CONCLUSIONS

This retrospective cohort study suggests that 2-year effectiveness of varenicline might be substantial in a real world setting. The abstinence rate was higher for those who also receive group therapy.

摘要

背景

伐尼克兰在临床试验中是一种有效的戒烟疗法。然而,其有效性在现实环境中可能有所不同,且其长期(2年)有效性尚未见报道。

目的

本研究旨在确定伐尼克兰在基层医疗环境中治疗烟草使用的有效性。

方法

采用观察性、多中心、回顾性研究,利用吸烟者的医疗记录随访24个月。评估社会人口学特征、合并症、治疗类型(伐尼克兰单独治疗或联合团体治疗)以及吸烟特征(法格斯特罗姆和里士满测试、开始吸烟年龄、每日吸烟量、戒烟尝试次数以及初始一氧化碳血氧仪测量值)。

结果

纳入773例接受伐尼克兰治疗(72.4%)或伐尼克兰联合团体治疗(27.6%)的吸烟者。平均年龄为43.6岁[男性占51.7%(n = 400)]。24个月时的持续戒烟率为44.4%,无显著性别或年龄差异。中位戒烟时间为398天(95%CI:376 - 421)。在24个月保持戒烟的概率与参与团体治疗(OR:1.877,95%CI:1.362 - 2.589)以及治疗依从性(依从性>80%)(OR:6.556,95%CI:5.870 - 7.242)之间存在明显关联,但与治疗共同付费情况(77%的患者有此情况)无关。伐尼克兰每服用一天,戒烟时间平均增加6.6天。

结论

这项回顾性队列研究表明,在现实环境中伐尼克兰的2年有效性可能相当可观。接受团体治疗者的戒烟率更高。

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