DeVuono Isabella R, Posa Stephanie, Lafond Naomy M C, Woodley Basilhea D, Coroiu Adina, Chaiton Michael O, Evans William K, Veldhuizen Scott, Zawertailo Laurie A, Melamed Osnat C, Eng Lawson, George Matthew M, Halligan Michelle H, Silverman Caroline B, Stewart Archie, Krames Lester, Bradley MaryAnn, Hussain Sarwar, Selby Peter, Minian Nadia
INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada.
Temerty Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
Cancer Control. 2025 Jan-Dec;32:10732748251359835. doi: 10.1177/10732748251359835. Epub 2025 Aug 1.
IntroductionSmoking cessation among individuals with cancer increases the effectiveness of cancer treatments and reduces the risks of death. However, individuals receiving cancer treatments in Ontario's 14 regional cancer centres are provided advice on the benefits of quitting smoking and referrals to smoking cessation treatments at different rates. This rapid systematic review was conducted, with funding from the Canadian Cancer Society, to update a published systematic review (Young et al, 2023) and to (1) identify implementation strategies and related implementation outcomes used in oncology settings; (2) describe the characteristics of these implementation strategies and implementation outcomes; and (3) determine whether specific implementation strategies are associated with increased smoking cessation efforts, referred to as the 3As (Ask, Advise, and Act) approach to smoking cessation.MethodsThis rapid systematic review was registered in The International Prospective Register of Systematic Reviews (registration number CRD42023491391). Three databases were searched for relevant studies: MEDLINE, Embase, and Cochrane Library. The quality of included studies was assessed based on their study design and narrative synthesis was used to summarize the data extracted.Results3158 studies were found, and eighteen new studies met our inclusion criteria. All eighteen studies had a low to moderate risk of bias. The implementation strategies training and educating stakeholders, using evaluative and iterative strategies, providing interactive assistance, supporting clinicians, and developing stakeholder interrelationships were associated with increased asking, advising, and acting, although these associations do not imply causality. Only 5 studies measured implementation outcomes; however, heterogeneity in the measurement tools used prevented analysis.ConclusionAlthough abundant data on implementation strategies was found, implementation outcomes were sparse and connections between the implementation strategies and implementation outcomes could not be drawn. Future studies should pilot the implementation strategies associated with increased asking, advising, and acting, and measure their success, considering both implementation strategies and implementation outcomes, as this information is lacking in the current literature.
引言
癌症患者戒烟可提高癌症治疗效果并降低死亡风险。然而,安大略省14个区域癌症中心接受癌症治疗的患者,在获得戒烟益处的建议以及转介至戒烟治疗方面的比例各不相同。在加拿大癌症协会的资助下,开展了这项快速系统评价,以更新已发表的系统评价(Young等人,2023年),并(1)确定肿瘤学环境中使用的实施策略及相关实施结果;(2)描述这些实施策略和实施结果的特征;(3)确定特定的实施策略是否与增加戒烟努力相关,即戒烟的3A(询问、建议和行动)方法。
方法
本快速系统评价已在国际系统评价前瞻性注册库中注册(注册号CRD42023491391)。检索了三个数据库以查找相关研究:MEDLINE、Embase和Cochrane图书馆。根据研究设计评估纳入研究的质量,并使用叙述性综合分析来总结提取的数据。
结果
共检索到3158项研究,18项新研究符合纳入标准。所有18项研究的偏倚风险为低到中度。实施策略培训和教育利益相关者、使用评估和迭代策略、提供互动协助、支持临床医生以及发展利益相关者的相互关系与增加询问、建议和行动相关,尽管这些关联并不意味着因果关系。只有5项研究测量了实施结果;然而,所用测量工具的异质性妨碍了分析。
结论
尽管发现了大量关于实施策略的数据,但实施结果却很稀少,无法得出实施策略与实施结果之间的联系。未来的研究应试点与增加询问、建议和行动相关的实施策略,并衡量其成功与否,同时考虑实施策略和实施结果,因为当前文献中缺乏这些信息。