通过移动干预提高尼古丁替代疗法的使用和依从性：墨西哥一项单臂可行性研究的二次数据分析
Enhancing nicotine replacement therapy usage and adherence through a mobile intervention: Secondary data analysis of a single-arm feasibility study in Mexico.
作者信息
Cartujano-Barrera Francisco, Rodríguez-Bolaños Rosibel, Arana-Chicas Evelyn, Gallegos-Carrillo Katia, N Flores Yvonne, Pérez-Rubio Gloria, Falfán-Valencia Ramcés, F Ellerbeck Edward, Reynales-Shigematsu Luz Myriam, Cupertino Ana Paula
机构信息
Department of Cancer Prevention and Control, Hackensack University Medical Center, Hackensack, United States.
Departamento de Investigación sobre Tabaco, Instituto Nacional de Salud Pública, Cuernavaca, Mexico.
出版信息
Tob Induc Dis. 2020 May 4;18:36. doi: 10.18332/tid/120076. eCollection 2020.
INSTRODUCTION
Nicotine Replacement Therapy (NRT) is an effective treatment for smoking cessation. However, medication usage and adherence remain a challenge that contributes to low smoking cessation rates. In Mexico, 8 in 10 smokers are interested in quitting. However, only 6% of Mexican smokers use medication for smoking cessation. The objective of this study is to assess the feasibility and acceptability of a mobile health (mHealth) intervention to increase usage and adherence of NRT in Mexico.
METHODS
The study involves a secondary data analysis. Forty smokers were recruited to participate in a single-arm pilot study. Participants received an mHealth intervention that uses tablet-based decision support software to drive a 12-week text messaging smoking cessation program and pharmacotherapy support. The intervention allows two-way interactivity text messaging between participants and a tobacco treatment specialist. NRT was offered to participants in accordance with practice guidelines in Mexico. Outcome measures included utilization of NRT, text messaging interactivity with the program, and biochemically verified abstinence at 12 weeks.
RESULTS
Thirty smokers met the criteria for use of NRT. Average age of participants was 38.1 years (SD=10.7), and they were primarily male (56.7%) with at least an undergraduate degree (60%). All participants requested NRT at baseline, and 60% requested a refill at week 4. During the 12-week intervention period, participants sent 620 messages to the program (mean=20.6, SD=18.34) of which 79 messages (12.7%) were related to NRT. Three themes were identified in the messages related to NRT: enthusiasm, instructions, and side effects. At 12 weeks, 40% of participants reported using NRT <75% of the days. Finally, 30% of participants (9/30) were biochemically verified abstinent using intention-to-treat analysis at 12 weeks.
CONCLUSIONS
An mHealth intervention appears to offer a promising strategy to increase usage and adherence of NRT in Mexico. Additional testing as a formal randomized clinical trial appears warranted.
引言
尼古丁替代疗法（NRT）是一种有效的戒烟治疗方法。然而，药物使用和依从性仍然是一个挑战，导致戒烟成功率较低。在墨西哥，十分之八的吸烟者有戒烟意愿。然而，只有6%的墨西哥吸烟者使用药物来戒烟。本研究的目的是评估一种移动健康（mHealth）干预措施在墨西哥提高NRT使用和依从性的可行性和可接受性。
方法
该研究涉及二次数据分析。招募了40名吸烟者参与单臂试点研究。参与者接受了一项mHealth干预，该干预使用基于平板电脑的决策支持软件来推动为期12周的短信戒烟计划和药物治疗支持。该干预允许参与者与烟草治疗专家之间进行双向互动短信。根据墨西哥的实践指南向参与者提供NRT。结果指标包括NRT的使用情况、与该计划的短信互动情况以及12周时经生化验证的戒烟情况。
结果
30名吸烟者符合使用NRT的标准。参与者的平均年龄为38.1岁（标准差=10.7），他们主要为男性（56.7%），至少拥有本科学历（60%）。所有参与者在基线时都要求使用NRT，60%的人在第4周要求补充药物。在为期12周的干预期内，参与者向该计划发送了620条信息（平均=20.6，标准差=18.34），其中79条信息（12.7%）与NRT有关。在与NRT相关的信息中确定了三个主题：热情、指导和副作用。在12周时，40%的参与者报告NRT的使用天数<75%。最后，在12周时使用意向性分析，30%的参与者（9/30）经生化验证已戒烟。
结论
一种mHealth干预措施似乎为提高墨西哥NRT的使用和依从性提供了一种有前景的策略。作为正式的随机临床试验进行额外测试似乎是必要的。
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