Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC.
Department of Medicine, Division of General Medicine, Duke University School of Medicine, Durham, NC.
Nicotine Tob Res. 2018 Sep 4;20(10):1163-1172. doi: 10.1093/ntr/ntx210.
Efficacious pharmacological interventions for smoking cessation are available, but poor adherence to these treatments may limit these interventions overall impact. To improve adherence to smoking cessation interventions, it is first necessary to identify and understand smoker-level characteristics that drive nonadherence (ie, nonconformance with a provider's recommendation of timing, dosage, or frequency of medication-taking during the prescribed length of time).
We present a literature review of studies examining correlates of, or self-reported reasons for, nonadherence to smoking cessation pharmacotherapies. Studies were identified through PubMed-using MeSH terms, Embase-using Emtree terms, and ISI Web of Science.
This literature review included 50 studies that examined nonpreventable (eg, sociodemographics) and preventable (eg, forgetfulness) factors associated with adherence to smoking cessation medication and suggestions for overcoming some of the identified barriers. Systematic study of this topic would be facilitated by consistent reporting of adherence and correlates thereof in the literature, development of consistent definitions of medication adherence across studies, utilization of more objective measures of adherence (eg, blood plasma levels vs. self-report) in addition to reliance on self-reported adherence.
This article provides the most comprehensive review to date on correlates of adherence to pharmacological smoking cessation interventions. Challenges and specific gaps in the literature that should be a priority for future research are discussed. Future priorities include additional research, particularly among vulnerable populations of smokers, developing standardized definitions of adherence and methods for measuring adherence, regular assessment of cessation pharmacotherapy adherence in the context of research and clinical practice, and development of novel treatments aimed at preventable barriers to medication adherence.
有效的戒烟药物干预措施已经存在，但这些治疗方法的依从性差可能会限制其整体效果。为了提高戒烟干预措施的依从性，首先需要确定和了解导致不依从的吸烟者个体特征（即，在规定的时间内不遵守提供者关于药物服用时间、剂量或频率的建议）。
我们对研究吸烟戒断药物治疗依从性相关因素或自我报告的不依从原因的文献进行了综述。通过使用 MeSH 术语的 PubMed、使用 Emtree 术语的 Embase 和 ISI Web of Science 进行了研究检索。
本文献综述包括 50 项研究，这些研究检查了与戒烟药物依从性相关的不可避免（例如，社会人口统计学）和可避免（例如，健忘）因素，并提出了克服一些已确定障碍的建议。如果文献中能一致地报告依从性及其相关因素、在研究之间建立一致的药物依从性定义、除了依赖自我报告的依从性外，还利用更客观的依从性衡量指标（例如，血浆水平与自我报告），那么对这一主题的系统研究将变得更加便利。
本文提供了迄今为止关于药物戒烟干预措施依从性相关因素的最全面综述。讨论了文献中的挑战和具体差距，这些应成为未来研究的优先事项。未来的重点包括：在脆弱的吸烟人群中进行更多的研究，制定依从性的标准化定义和测量方法，在研究和临床实践中定期评估戒烟药物治疗的依从性，以及开发旨在解决药物依从性的可避免障碍的新疗法。
