哮喘联盟

   摘要
   前言：尼古丁替代治疗（NRT）已经证实能提高戒断率。然而，缺少很好的证据来描述初级医疗机构中的患者如何使用NRT、哪些因素可影响NRT。本试验旨在描述NRT的依从性、使用情况，研究决定NRT使用的关键因素以及NRT使用与戒断的关系。
   方法：对初级医疗机构中进行的戒烟随机、对照临床试验数据进行二次分析。对戒烟门诊启动戒烟尝试的成人吸烟者（n = 633）随访6个月，同时采用NRT治疗，并自治疗开始观察4周。主要转归为4周内对NRT的依从性、4周内平均每天NRT的用药量以及4周时的戒断率。
   结果：受试者对NRT的依从性较高，超过94%的受试者完成治疗。在对可能的混杂因素进行校正后，处方高剂量的贴剂和口服NRT与每日NRT用药量较高相关。采用吸入器给予口服NRT与较高的依从性和较高的治疗剂量相关。NRT用药量与预测的未来戒断率呈反向因果关系。
   结论：在初级医疗机构中，参与临床试验的大部分持续戒烟尝试者对处方的NRT有较好的依从性。处方较大剂量NRT可导致用药剂量变大，后者与较高的戒断率相关。
 

(林江涛 审校)
Nicotine Tob Res. 2013 Feb 19. [Epub ahead of print]

 

Adherence to and Consumption of Nicotine Replacement Therapy and the Relationship With Abstinence Within a Smoking Cessation Trial in Primary Care.
 
Hollands GJ, Sutton S, McDermott MS, Marteau TM, Aveyard P.

Source
Psychology Department (at Guy's), King's College London, London, SE1 9RT, UK;

Abstract 
INTRODUCTION: Nicotine replacement therapy (NRT) medications have been shown to be effective in increasing smoking cessation rates. There is, however, a lack of good evidence describing how individuals in primary care use these medications and which factors are likely to affect this. The study objectives are to describe adherence and consumption, examine key factors that may determine use, and examine the relationship between consumption of NRT and abstinence from smoking.
METHODS: Secondary analysis of data from a randomized controlled trial conducted in smoking cessation services in primary care. Adult smokers (n = 633) starting a quit attempt within smoking cessation clinics were followed for 6 months, with NRT use closely monitored for an initial treatment period of 4 weeks. The main outcomes were 4-week adherence to prescribed NRT, mean daily consumption of NRT over the 4-week period, and abstinence from smoking at 4 weeks.
RESULTS: Levels of adherence to prescribed NRT were high: more than 94% in participants who completed the treatment period. After controlling for possible confounders, prescribing higher doses of patch and oral NRT was associated with higher mean daily consumption of NRT. Using an inhalator to deliver oral NRT was associated with both higher adherence and higher consumption. The amount of NRT consumed predicted future abstinence when reverse causation was accounted for.
CONCLUSIONS: Most individuals within a clinical trial in primary care who persisted with a quit attempt adhered closely to their prescription. Prescribing higher doses of NRT led to higher consumption and higher consumption to higher abstinence.
 

Nicotine Tob Res. 2013 Feb 19. [Epub ahead of print]