The Queensland Research Centre for Peripheral Vascular Disease (QRC-PVD), College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia; The Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Queensland, Australia.
The Queensland Research Centre for Peripheral Vascular Disease (QRC-PVD), College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia; The Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Queensland, Australia; The Department of Vascular and Endovascular Surgery, Townsville University Hospital, Townsville, Queensland, Australia.
J Vasc Surg. 2022 Feb;75(2):721-729.e7. doi: 10.1016/j.jvs.2021.07.248. Epub 2021 Sep 30.
This review aimed to systematically pool evidence from randomized clinical trials on the efficacy of interventions in assisting smoking cessation in participants with peripheral artery disease (PAD).
Publicly available databases were searched for randomized clinical trials testing the effect of interventional programs in achieving smoking cessation in participants with PAD who were current smokers. The primary outcome was smoking cessation at the end of follow-up. Meta-analyses were performed using random effect models and reported as risk ratios and 95% confidence intervals. Risk of bias and publication bias were assessed using a modified version of the Cochrane Collaboration's tool and funnel plots, respectively.
Six randomized clinical trials testing smoking cessation programs comprising physician advice, behavioral counselling from an expert delivered in-person or over the telephone, and the provision of nicotine replacement therapy and/or varenicline in 558 smokers with PAD were included. A meta-analysis suggested that, overall, these interventions did not significantly increase the chance of quitting smoking (risk ratio, 1.48; 95% confidence interval, 0.84-2.61), with low heterogeneity between studies (I = 20%), which were robust in sensitivity analyses. Risk of bias was high, moderate, and low in one, three, and two studies respectively. A funnel plot suggested a low risk of publication bias.
Overall, previously tested smoking cessation interventions have not been effective in achieving smoking cessation in people with PAD. Further research is needed to develop and test interventions that can effectively help current smokers with PAD to quit.
本综述旨在系统地汇集关于干预措施在协助外周动脉疾病（PAD）患者戒烟方面有效性的随机临床试验证据。
检索公开数据库，以寻找测试干预计划在实现 PAD 且目前吸烟的参与者戒烟效果的随机临床试验。主要结局是随访结束时的戒烟情况。使用随机效应模型进行荟萃分析，并报告风险比和 95%置信区间。使用 Cochrane 协作工具的修改版本和漏斗图分别评估偏倚风险和发表偏倚。
纳入了 6 项随机临床试验，这些试验测试了包括医生建议、由专家亲自或通过电话提供的行为咨询、以及提供尼古丁替代疗法和/或伐伦克林在内的戒烟计划，涉及 558 名 PAD 吸烟者。荟萃分析表明，总体而言，这些干预措施并没有显著增加戒烟的机会（风险比，1.48；95%置信区间，0.84-2.61），研究之间的异质性较低（I=20%），在敏感性分析中也具有稳健性。分别有一项、三项和两项研究的偏倚风险为高、中、低。漏斗图表明发表偏倚的风险较低。
总体而言，以前测试的戒烟干预措施在帮助 PAD 患者戒烟方面并不有效。需要进一步研究以开发和测试可以有效帮助有 PAD 的当前吸烟者戒烟的干预措施。
