VA HSR&D Center for Care Delivery and Outcomes Research (CCDOR), VA Medical Center (152), Minneapolis VA Health Care System, Minneapolis, MN, USA.
Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA.
J Behav Med. 2020 Jun;43(3):493-502. doi: 10.1007/s10865-019-00083-8. Epub 2019 Jul 30.
Smokers with serious mental illness (SMI) face individual, interpersonal, and healthcare provider barriers to cessation treatment utilization and smoking abstinence. Proactive outreach strategies are designed to address these barriers by promoting heightened contact with smokers and facilitating access to evidence-based treatments. The present study examined the effect of proactive outreach among smokers with SMI (n = 939) who were enrolled in the publicly subsidized Minnesota Health Care Programs (MHCP) and compared this effect to that observed among MHCP smokers without SMI (n = 1382). Relative to usual care, the intervention increased treatment utilization among those with SMI (52.1% vs 40.0%, p = 0.002) and without SMI (39.3% vs 25.4%, p < 0.001). The intervention also increased prolonged smoking abstinence among those with SMI (14.9% vs 9.4%, p = 0.010) and without SMI (17.7% vs 13.6%, p = 0.09). Findings suggest that implementation of proactive outreach within publicly subsidized healthcare systems may alleviate the burden of smoking in this vulnerable population. Trial Registration ClinicalTrials.gov identifier: NCT01123967.
患有严重精神疾病（SMI）的吸烟者在戒烟治疗的利用和戒烟方面面临个人、人际和医疗服务提供者的障碍。主动外展策略旨在通过增加与吸烟者的接触并促进获得基于证据的治疗来解决这些障碍。本研究调查了在参加明尼苏达州医疗保健计划（MHCP）的患有 SMI 的吸烟者（n=939）中实施主动外展的效果，并将其与没有 SMI 的 MHCP 吸烟者（n=1382）的效果进行了比较。与常规护理相比，干预措施增加了 SMI 患者（52.1%对 40.0%，p=0.002）和无 SMI 患者（39.3%对 25.4%，p<0.001）的治疗利用率。干预措施还增加了 SMI 患者（14.9%对 9.4%，p=0.010）和无 SMI 患者（17.7%对 13.6%，p=0.09）的长期戒烟率。研究结果表明，在公共补贴的医疗保健系统中实施主动外展可能会减轻这一弱势群体的吸烟负担。试验注册 临床试验.gov 标识符：NCT01123967。
