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基于肺活量测定结果的动机干预对实现初级保健患者戒烟效果的随机、平行、对照多中心研究。

Effectiveness of a motivational intervention based on spirometry results to achieve smoking cessation in primary healthcare patients: randomised, parallel, controlled multicentre study.

机构信息

Direcció d'Atenció Primària, Camp de Tarragona, Institut Català de la Salut, Tarragona, Spain

Unitat de Suport a la Recerca Tarragona-Reus, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Reus, Spain.

出版信息

J Epidemiol Community Health. 2021 Oct;75(10):1001-1009. doi: 10.1136/jech-2020-216219. Epub 2021 Apr 21.

Abstract

OBJECTIVE

This 12-month study in a primary healthcare network aimed to assess the effectiveness of usual smoking cessation advice compared with personalised information about the spirometry results.

DESIGN

Randomised, parallel, controlled, multicentre clinical trial.

SETTING

This study involved 12 primary healthcare centres (Tarragona, Spain).

PARTICIPANTS

Active smokers aged 35-70 years, without known respiratory disease. Each participant received brief smoking cessation advice along with a spirometry assessment. Participants with normal results were randomised to the intervention group (IG), including detailed spirometry information at baseline and 6-month follow-up or control group (CG), which was simply informed that their spirometry values were within normal parameters.

MAIN OUTCOME

Prolonged abstinence (12 months) validated by expired-CO testing.

RESULTS

Spirometry was normal in 571 patients in 571 patients (45.9% male), 286 allocated to IG and 285 to CG. Baseline characteristics were comparable between the groups. Mean age was 49.8 (SD ±7.78) years and mean cumulative smoking exposure was 29.2 (±18.7) pack-years. Prolonged abstinence was 5.6% (16/286) in the IG, compared with 2.1% (6/285) in the CG (p=0.03); the cumulative abstinence curve was favourable in the IG (HR 1.98; 95% CI 1.29 to 3.04).

CONCLUSIONS

In active smokers without known respiratory disease, brief advice plus detailed spirometry information doubled prolonged abstinence rates, compared with brief advice alone, in 12-month follow-up, suggesting a more effective intervention to achieve smoking cessation in primary healthcare.

TRIAL REGISTRATION NUMBER

NCT01194596.

摘要

目的

这项在初级医疗保健网络中进行的为期 12 个月的研究旨在评估与常规戒烟建议相比,个性化的肺功能测试结果信息对戒烟的效果。

设计

随机、平行、对照、多中心临床试验。

地点

这项研究涉及西班牙塔拉戈纳的 12 个初级保健中心。

参与者

年龄在 35-70 岁、无已知呼吸道疾病的主动吸烟者。每位参与者都接受了简短的戒烟建议和肺功能测试。肺功能测试结果正常的参与者被随机分配到干预组(IG),包括基线和 6 个月随访时的详细肺功能测试信息,或对照组(CG),仅被告知他们的肺功能测试值在正常范围内。

主要结果

通过呼气一氧化碳检测验证的 12 个月持续戒烟。

结果

在 571 名患者中(45.9%为男性),571 名患者的肺功能测试结果正常,其中 286 名被分配到 IG,285 名被分配到 CG。两组的基线特征相似。平均年龄为 49.8(±7.78)岁,平均累计吸烟量为 29.2(±18.7)包年。IG 组的持续戒烟率为 5.6%(16/286),CG 组为 2.1%(6/285)(p=0.03);IG 组的累积戒烟曲线更为有利(HR 1.98;95%CI 1.29 至 3.04)。

结论

在无已知呼吸道疾病的主动吸烟者中,与仅接受简短建议相比,在 12 个月的随访中,简短建议加详细的肺功能测试信息使持续戒烟率增加了一倍,提示初级医疗保健中更有效的戒烟干预措施。

试验注册

NCT01194596。

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