Neil J M, Price S N, Friedman E R, Ponzani C, Ostroff J S, Muzikansky A, Park E R
Harvard Medical School/Massachusetts General Hospital, Boston, MA, USA.
University of Arizona, Tucson, AZ, USA.
Tob Use Insights. 2020 Aug 17;13:1179173X20949270. doi: 10.1177/1179173X20949270. eCollection 2020.
A cancer diagnosis is seen as a "teachable moment" for patients to consider changing their behavioral risk factors, such as smoking. It also offers an opportunity for oncology providers to engage in a dialogue about how they can support patients changing their smoking behaviors. Brief, evidence-based tobacco cessation treatment delivered by oncology providers through the 5As (Ask, Advise, Assess, Assist Arrange) model is recommended, but provision to cancer patients remains suboptimal.
Explore patient-level factors associated with 5As receipt among current smokers with a newly diagnosed cancer.
A total of 303 patients self-reported whether they received each of the 5As during their most recent oncology care visit. Multivariable regression analyses were conducted to identify patient-level factors associated with 5As receipt.
Oncology provider-delivered 5As rates ranged from 81.5% (Ask) to 30.7% (Arrange). 5As receipt was associated with: reporting lower illness-related stigma, diagnosis of a comorbid smoking-related disease, diagnosis of a smoking-related cancer, and diagnosis of a non-advanced cancer.
Findings support previous literature in which smoking-related diagnoses were associated with greater receipt of 5As; however, disparities in the receipt of 5As existed for patients with more advanced cancer diagnoses and illness-related stigma. Inequities in the provision of quit assistance may further decrease treatment effectiveness and survival expectancy among certain patient populations. These findings are, therefore, important as they identify specific patient-level factors associated with lower 5As receipt among newly diagnosed cancer patients.
癌症诊断被视为患者考虑改变行为风险因素(如吸烟)的“教育契机”。它也为肿瘤学医护人员提供了一个机会,就如何支持患者改变吸烟行为展开对话。推荐肿瘤学医护人员通过5A(询问、建议、评估、协助、安排)模式提供简短的、基于证据的戒烟治疗,但向癌症患者提供的情况仍不理想。
探讨新诊断癌症的现吸烟者中与接受5A相关的患者层面因素。
共有303名患者自我报告在其最近一次肿瘤护理就诊期间是否接受了5A中的每一项。进行多变量回归分析以确定与接受5A相关的患者层面因素。
肿瘤学医护人员提供5A的比例从81.5%(询问)到30.7%(安排)不等。接受5A与以下因素相关:报告较低的疾病相关耻辱感、合并吸烟相关疾病的诊断、吸烟相关癌症的诊断以及非晚期癌症的诊断。
研究结果支持先前的文献,即吸烟相关诊断与更多接受5A相关;然而,对于癌症诊断更晚期和有疾病相关耻辱感的患者,在接受5A方面存在差异。戒烟援助提供方面的不平等可能会进一步降低某些患者群体的治疗效果和预期寿命。因此,这些发现很重要,因为它们确定了新诊断癌症患者中与较少接受5A相关的特定患者层面因素。