行为干预戒烟——一项meta-分析
2009/07/30
目的:很多用RCT评估行为干预戒烟的作用的文献已经发表，以前的有关行为干预戒烟meta-分析有严重的局限性，而且没有包括最近RCT。我们采用的meta-分析来综合种行为干预的作用，包括最小的临床干预（保健人员提供的简短的建议）和强干预包括：个体的，群体的，和电话劝告。
方法和结果：检索CDC烟草信息和预防，协作网图书馆，EMBASE, Medline, and PsycINFO数据库，只纳入生物化学确认的目标戒烟日后6个月和或12月作为结果的RCTs，结果的聚集采用等级贝叶斯随机效应模型。同一50个RCTs，26 927个患者（最小临床干预：9个实验，n = 6456; 个体的劝说: 23 RCTs, n = 8646; 群体劝说: 12 RCTs, n = 3600; 电话劝说: 10 RCTs, n = 8225).平均的评价是最小临床干预 [OR：1.50, 95% CrI:0.84-2.78], 个体的劝说(OR 1.49, 95% CrI 1.08-2.07), 群体劝说(OR 1.76, 95% CrI 1.11-2.93), 电话劝说(OR 1.58, 95% CrI 1.15-2.29).
结论:和对照相比，强烈的行为干预能够大幅度提高戒烟成功的机会。虽然最小的临床干预可能会增加戒烟的成功率。但没有足够的证据来说明他的有效性。
（刘超武编译刘国梁审校）
Behavioural interventions for smoking cessation: a meta-analysis of randomized controlled trials.
Mottillo S, Filion KB, Bélisle P, Joseph L, Gervais A, O’Loughlin J, Paradis G, Pihl R, Pilote L, Rinfret S, Tremblay M, Eisenberg MJ.
Mottillo S, Filion KB, Bélisle P, Joseph L, Gervais A, O’Loughlin J, Paradis G, Pihl R, Pilote L, Rinfret S, Tremblay M, Eisenberg MJ.
Division of Cardiology and Clinical Epidemiology, Jewish General Hospital/McGill University, 3755 Côte Ste-Catherine Road, Suite A-118, Montreal, Quebec, Canada H3T 1E2.
Aims: Widely varying estimates of treatment effects have been reported in randomized controlled trials (RCTs) investigating the efficacy of behavioural interventions for smoking cessation. Previous meta-analyses investigating behavioural interventions have important limitations and do not include recently published RCTs. We undertook a meta-analysis of RCTs to synthesize the treatment effects of four behavioural interventions, including minimal clinical intervention (brief advice from a healthcare worker), and intensive interventions, including individual, group, and telephone counselling.
Methods and results: We searched the CDC Tobacco Information and Prevention, Cochrane Library, EMBASE, Medline, and PsycINFO databases. We included only RCTs that reported biochemically validated smoking cessation outcomes at 6 and/or 12 months after the target quit date. Outcomes were aggregated using hierarchical Bayesian random-effects models. We identified 50 RCTs, which randomized n = 26 927 patients (minimal clinical intervention: 9 RCTs, n = 6456; individual counselling: 23 RCTs, n = 8646; group counselling: 12 RCTs, n = 3600; telephone counselling: 10 RCTs, n = 8225). The estimated mean treatment effects were minimal clinical intervention [odds ratio (OR) 1.50, 95% credible interval (CrI) 0.84-2.78], individual counselling (OR 1.49, 95% CrI 1.08-2.07), group counselling (OR 1.76, 95% CrI 1.11-2.93), and telephone counselling (OR 1.58, 95% CrI 1.15-2.29).
Conclusion: Intensive behavioural interventions result in substantial increases in smoking abstinence compared with control. Although minimal clinical intervention may increase smoking abstinence, there is insufficient evidence to draw strong conclusions regarding its efficacy.
PMID: 19109354 [PubMed - as supplied by publisher]
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