1 St Louis College of Pharmacy, MO, USA.
2 Corum Health Services, Chesterfield, MO, USA.
Ann Pharmacother. 2018 Nov;52(11):1109-1116. doi: 10.1177/1060028018780448. Epub 2018 Jun 1.
Smoking during pregnancy has detrimental effects on mother and fetus. Text messaging has been utilized to improve patient care.
To evaluate the impact of text messaging on smoking cessation rates among pregnant women in addition to standard of care (SOC) smoking cessation services. Our SOC includes pharmacist-driven education with or without nicotine patch or bupropion.
This randomized, open-label, prospective trial was conducted at a maternal fetal care center from May 2014 to January 2016. Pregnant patients in the preparation stage of change were randomized to text messaging or SOC. The primary outcome was smoking cessation verified with exhaled carbon monoxide levels (eCO) 2 weeks from quit date. All received clinical pharmacist weekly calls for 3 weeks and biweekly visits until pharmacotherapy completion. The text messaging group also received predetermined motivational messages.
Of 49 randomized patients, 13 withdrew, and 6 were lost to follow-up. The remaining included 14 texting and 16 SOC patients. eCO-verified cessation was achieved by 57.1% in the texting group versus 31.3% in the control ( P = 0.153). Overall, 64.3% of the texting group achieved an eCO below 8 ppm at ≥1 visit versus 37.5% in the control group ( P = 0.143). No difference was found in birth outcomes. The study was underpowered because of slow enrollment and high drop-out rates.
Text messaging had minimal impact on improving smoking cessation rates in the obstetric population. However, further research is warranted because of the underpowered nature of this trial. Given the detrimental effects of smoking in pregnancy, more comprehensive cessation strategies are warranted.
孕期吸烟对母婴均有不良影响。已采用短信服务来改善患者护理。
评估短信服务对除标准护理（SOC）戒烟服务以外的孕妇戒烟率的影响。我们的 SOC 包括药剂师主导的教育，辅以尼古丁贴片或安非他酮。
这项随机、开放标签、前瞻性试验于 2014 年 5 月至 2016 年 1 月在一家母婴保健中心进行。处于改变准备阶段的孕妇被随机分配至短信服务组或 SOC 组。主要结局是通过戒烟 2 周后呼出的一氧化碳水平（eCO）来验证的戒烟情况。所有患者均接受临床药剂师每周 3 次、共 3 周的电话随访，以及直至药物治疗完成为止的每两周 1 次就诊。短信服务组还接受了预定的动机性短信。
49 名随机患者中，13 名退出，6 名失访。其余患者包括 14 名短信服务组和 16 名 SOC 组。短信服务组的 eCO 验证戒烟率为 57.1%，对照组为 31.3%（P=0.153）。总体而言，短信服务组中有 64.3%的患者在至少 1 次就诊时 eCO 低于 8 ppm，而对照组为 37.5%（P=0.143）。两组的分娩结局无差异。由于入组缓慢和高脱落率，该研究的效力不足。
短信服务对改善产科人群的戒烟率影响不大。但是，由于该试验的效力不足，需要进一步研究。鉴于吸烟对妊娠的不良影响，需要更全面的戒烟策略。
