Salepci Banu, Özdoğan Sevda, Altunok Elif Çiğdem, Naziroğlu Tuba, Kıral Nesrin, Parmaksız Elif Torun, Fidan Ali, Sağmen Seda Beyhan, Doğan Coşkun, Cömert Sevda Sener
Department of Chest Diseases, Yeditepe University School of Medicine, İstanbul, Turkey.
Department of Biostatistics and Medical Informatics, Yeditepe University School of Medicine, İstanbul, Turkey.
Turk Thorac J. 2021 Mar;22(2):110-117. doi: 10.5152/TurkThoracJ.2020.19111. Epub 2021 Mar 1.
This study aimed to compare the success rate of 3 different drug prescription policies: Free drugs with online system prescription, free drugs with doctor's prescription, and drugs paid for by patients with doctor's prescription.
The effect of 2 different Ministry of Health (MoH) projects with free-of-charge and self-payment pharmacotherapies for smoking cessation were compared. Patients who completed 6 months of pharmacotherapy and follow-up were evaluated. The first period was free-of-charge medication, which was determined by an online system, the following period was the self-payment period, and the third period was free medication, which was prescribed by a doctor. In all the groups, smoking habits in pack years and comorbidities of the patients were recorded, and pulmonary function tests (PFTs) and expiratory carbon dioxide (CO2) measurements were performed. Patients who had an expiratory CO2 level >5 ppm at the control visits were accepted as quitters.
A total of 829 patients with 438 patients in the first free-of-charge period (group 1), 111 in the self-payment period (group 2), and 280 in the second free-of-charge period (group 3) were enrolled in the study. Smoking cessation rates were significantly higher in the self-payment medication group (25%) according to the MoH's free-of-charge project groups. There was no difference in smoking cessation rates between the 2 free-of-charge medication project groups (15% in group 1 and 11% of group 3). Among all the patients, we compared 124 patients who quit smoking with 705 patients who did not. The quitters were older, mostly male, and heavier smokers. In addition, the number of patients with chronic obstructive pulmonary disease and obstructive PFT rates were higher among the quitters. Their dependency score, PFTs, and the use of free medication was lower, and treatment duration was longer. Independent factors that increased smoking cessation success were longer treatment duration, lower dependency score, and self-payment of medication.
Free medications provided via 2 different modalities did not increase the smoking cessation success. Paying for the medication, lower dependency score, and longer treatment duration increased smoking cessation success independently.
本研究旨在比较3种不同药物处方政策的成功率：在线系统处方免费药物、医生处方免费药物以及患者自付费用的医生处方药物。
比较了卫生部的2个不同项目（免费和自付药物疗法用于戒烟）的效果。对完成6个月药物治疗和随访的患者进行评估。第一阶段是由在线系统确定的免费药物治疗期，接下来是自付费用期，第三阶段是由医生开处方的免费药物治疗期。在所有组中，记录患者的吸烟包年习惯和合并症，并进行肺功能测试（PFT）和呼气二氧化碳（CO2）测量。在对照访视时呼气CO2水平>5 ppm的患者被视为戒烟者。
共有829例患者参与研究，其中第一免费期（第1组）438例，自付费用期（第2组）111例，第二免费期（第3组）280例。根据卫生部的免费项目组，自付药物治疗组的戒烟率（25%）显著更高。2个免费药物治疗项目组之间的戒烟率没有差异（第1组为15%，第3组为11%）。在所有患者中，我们比较了124例戒烟患者和705例未戒烟患者。戒烟者年龄更大，大多为男性，吸烟量更大。此外，戒烟者中慢性阻塞性肺疾病患者数量和阻塞性PFT率更高。他们的依赖评分、PFT以及免费药物使用更低，治疗持续时间更长。增加戒烟成功率的独立因素是更长的治疗持续时间、更低的依赖评分以及药物自付费用。
通过2种不同方式提供的免费药物并未提高戒烟成功率。药物付费、更低的依赖评分以及更长的治疗持续时间独立地提高了戒烟成功率。
