在肺癌查中优化纵向戒烟治疗:一个顺序,多重分配,随机试验
Steven S Fu1,2, Alexander J Rothman3, David M Vock4
1Veterans Affairs Health Services Research and Development Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, Minnesota.
JAMA network open
|August 24, 2023
概括
添加药物治疗管理到烟草纵向护理并没有改善对初始治疗没有反应的肺癌查患者的戒烟. 减少响应者的护理强度也没有任何好处. 将戒烟护理与查相结合是可行的.
科学领域:
- 肺部病理学 肺部病理学
- 在瘤学瘤学.
- 成 药物 药物 药物 药物
背景情况:
- 肺癌查 (LCS) 的资格包括近一半的美国成年人吸烟.
- 在LCS设置中的最佳戒烟计划组件仍然不清楚.
- 需要有效的干预措施来支持这一高风险人群戒烟.
研究的目的:
- 评估将药物治疗管理 (MTM) 添加到烟草纵向护理 (TLC) 的影响,对于那些不响应早期烟草治疗的LCS合格吸烟者.
- 评估降低LCS强度 (季度接触) 对LCS符合条件的吸烟者,但对早期治疗有反应的影响.
主要方法:
- 一项随机临床试验,涉及每日吸烟者符合LCS的条件.
- 参与者来自美国三大医疗系统的初级保健和LCS计划.
- 干预措施包括密集的TLC,MTM转诊的TLC和减少强度的季度TLC,根据早期治疗反应分配.
主要成果:
- 总体而言,在18个月的6个月内,长期戒烟率为24.4%.
- 在早期不响应者中,将MTM添加到TLC中并没有显著改善戒断率 (17.8%与16.4%相比).
- 降低早期响应者TLC强度并没有改善禁欲 (43.6%对58.6%).
结论:
- 在LCS环境中,将MTM与TLC一起推送并不能增强非响应者的吸烟戒断.
- 对于早期反应者来说,不建议降低TLC强度.
- 将纵向的戒烟护理与LCS整合起来是可行的,并且产生了临床上有意义的戒烟率.
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