在一个独立的农村社区药房，采用随机析因设计测试戒烟辅助戒烟干预措施的可行性。
Testing the feasibility of the QuitAid smoking cessation intervention in a randomized factorial design in an independent, rural community pharmacy.
作者信息
Little Melissa A, Reid Taylor, Moncrief Matthew, Cohn Wendy, Wiseman Kara P, Wood Candace H, You Wen, Anderson Roger T, Krukowski Rebecca A
机构信息
Department of Public Health Sciences, University of Virginia, School of Medicine, PO Box 800765, Charlottesville, VA, 22908-0765, USA.
Cancer Control and Population Health, University of Virginia Cancer Center, Charlottesville, VA, USA.
出版信息
Pilot Feasibility Stud. 2024 Feb 26;10(1):41. doi: 10.1186/s40814-024-01465-9.
BACKGROUND
Adult smoking rates in the USA are highest in economically depressed rural Appalachia. Pharmacist-delivered tobacco cessation support that incorporates medication therapy management (such as the QuitAid intervention) is a promising approach to address this need.
METHODS
Twenty-four adult smokers recruited between September and November 2021 through an independent pharmacy in rural Appalachia were randomized in a non-blinded 2 × 2 × 2 factorial design to (1) pharmacist delivered QuitAid intervention (yes vs. no); (2) combination nicotine replacement therapy (NRT) gum + NRT patch (vs. NRT patch); and/or (3) 8 weeks of NRT (vs. standard 4 weeks). Participants received 4 weeks of NRT patch in addition to the components to which they were assigned. Participants completed baseline and 3-month follow-up assessments. Primary outcomes were feasibility of recruitment and randomization, retention, treatment adherence, and fidelity.
RESULTS
Participants were recruited in 7 weeks primarily through a referral process, commonly referred to as ask-advise-connect (61%). Participants were on average 52.4 years old, 29.2% were male and the majority were white (91.6%) and Non-Hispanic (91.7%). There was a high level of adherence to the interventions, with 85% of QuitAid sessions completed, 83.3% of the patch used, and 54.5% of gum used. Participants reported a high level of satisfaction with the program, and there was a high level of retention (92%).
CONCLUSIONS
This demonstration pilot randomized controlled study indicates that an ask-advise-connect model for connecting rural smokers to smoking cessation support and providing QuitAid for smoking cessation is feasible and acceptable among rural Appalachian smokers and independent pharmacists. Further investigation into the efficacy of a pharmacist-delivered approach for smoking cessation is needed.
TRIAL REGISTRATION
The trial was retrospectively registered at ClinicalTrials.gov. Trial #: NCT05649241.
背景
美国成年人吸烟率在经济萧条的阿巴拉契亚农村地区最高。由药剂师提供的结合药物治疗管理的戒烟支持（如戒烟援助干预）是满足这一需求的一种有前景的方法。
方法
2021年9月至11月期间，通过阿巴拉契亚农村地区的一家独立药房招募了24名成年吸烟者，采用非盲2×2×2析因设计将他们随机分为：（1）由药剂师提供戒烟援助干预（是与否）；（2）联合尼古丁替代疗法（NRT）口香糖+NRT贴片（与NRT贴片相比）；和/或（3）8周的NRT（与标准的4周相比）。参与者除了接受分配的组件外，还接受4周的NRT贴片。参与者完成了基线和3个月的随访评估。主要结果是招募和随机分组的可行性、保留率、治疗依从性和保真度。
结果
参与者主要通过一种通常称为询问-建议-联系的推荐过程在7周内招募完成（61%）。参与者平均年龄为52.4岁，29.2%为男性，大多数是白人（91.6%）且非西班牙裔（91.7%）。对干预措施的依从性很高，85%的戒烟援助课程完成，83.3%的贴片被使用，54.5%的口香糖被使用。参与者对该项目满意度很高，保留率也很高（92%）。
结论
这项示范性试点随机对照研究表明，在农村阿巴拉契亚吸烟者和独立药剂师中，通过询问-建议-联系模式将农村吸烟者与戒烟支持联系起来并提供戒烟援助进行戒烟是可行且可接受的。需要进一步研究药剂师提供的戒烟方法的疗效。
试验注册
该试验在ClinicalTrials.gov上进行了回顾性注册。试验编号：NCT05649241。
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