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与医院流程同时进行的戒烟和减少饮酒的简短咨询:一项随机临床试验。

Brief counseling for smoking cessation and alcohol use reduction concomitant with hospital procedures: a randomized clinical trial.

机构信息

Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia. Servicio de Consulta Externa, Hospital Universitario San Ignacio, Bogotá, Colombia.

Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia. Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Bogotá, Colombia.

出版信息

Braz J Psychiatry. 2022 Aug 29;44(5):507-516. doi: 10.47626/1516-4446-2021-2413.

Abstract

OBJECTIVE

To evaluate the effect of brief counseling on patient readiness for behavioral change and cessation/reduction of tobacco and alcohol use.

METHODS

This clinical trial randomized patients in blocks, stratified by risk factor. Adult smokers or at-risk drinkers undergoing surgical or diagnostic procedures were recruited. Outcome assessments and analyses were blinded. Brief counseling was compared with educational materials for the outcomes progress in stage of change and smoking/alcohol cessation/reduction.

RESULTS

Overall, 222 participants were randomly assigned to the intervention group and 218 to the control group. Among them, 28 and 18 patients were lost to follow-up, respectively. Progress in change stage was 94.1% at 1 month in both groups (RR = 1.00; 95%CI 0.95-1.05) and 94.8 vs. 90.5% at 3 months (RR = 1.05; 95%CI 0.99-1.11) in the intervention and control groups, respectively. Smoking cessation and alcohol reduction rates at 3 months were 57.2 vs. 41% (RR = 1.40; 95%CI 1.14-1.71) in the intervention and control groups, respectively. Only brief counseling led to significant differences in smoking cessation (51.4 vs. 35.1%; RR = 1.46; 95%CI 1.12-1.92).

CONCLUSIONS

Brief counseling and educational materials improved patient motivation for behavioral change, but brief counseling had a greater effect on smoking cessation.

摘要

目的

评估简短咨询对患者准备进行行为改变以及停止/减少吸烟和饮酒的影响。

方法

本临床试验采用区组随机化方法,按危险因素分层。纳入接受手术或诊断程序的成年吸烟者或有风险的饮酒者。对结果评估和分析采用盲法。将简短咨询与教育材料进行比较,以评估其在改变阶段进展和戒烟/减少饮酒方面的效果。

结果

共有 222 名参与者被随机分配到干预组,218 名参与者被分配到对照组。其中,分别有 28 名和 18 名患者失访。在两组中,1 个月时改变阶段的进展率均为 94.1%(RR=1.00;95%CI 0.95-1.05),3 个月时分别为 94.8%和 90.5%(RR=1.05;95%CI 0.99-1.11)。干预组和对照组在 3 个月时的戒烟和减少饮酒率分别为 57.2%和 41%(RR=1.40;95%CI 1.14-1.71)。只有简短咨询导致戒烟方面有显著差异(51.4%比 35.1%;RR=1.46;95%CI 1.12-1.92)。

结论

简短咨询和教育材料可提高患者进行行为改变的动机,但简短咨询对戒烟的效果更大。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97c3/9561838/bf72f11e7e80/bjp-44-05-507-g001.jpg

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