在社区卫生环境中实施专业烟草使用障碍服务:支持加强处方实践
Lindsay R Meredith1, Brian Hurley, Theodore C Friedman
1From the Department of Psychology, University of California, Los Angeles, Los Angeles, CA (LRM, LAR); Los Angeles County Department of Public Health, Los Angeles, CA (BH); Friends Research Institute, Cerritos, CA (BH, TCF, LR, BL, NM, TD); Los Angeles County Department of Health Services, Los Angeles, CA (TCF, HKB, SH); Department of Internal Medicine, Charles R. Drew University, Los Angeles, CA (TCF, MLL); Department of Biostatistics, University of California, Los Angeles, Los Angeles, CA (MLL); Brain Research Institute, University of California, Los Angeles, Los Angeles, CA (LAR); and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA (LAR).
专业服务显著增加了社区诊所中烟草治疗药物的处方率. 这种方法有望减少风险人群中吸烟障碍和健康差异.
科学领域:
- 公共卫生 公共卫生
- 实施科学 实施科学
- 健康差异 在健康上的差异
背景情况:
- 数以百万计的美国成年人继续吸烟,导致烟草使用障碍 (TUD) 的重大公共卫生负担.
- 解决TUD及其相关的健康差异需要加强对基于证据的治疗服务的可访问性,特别是对资源不足的社区.
研究的目的:
- 评估提供专业TUD服务的社区卫生诊所是否在与提供标准护理的诊所相比,在处方基于证据的戒烟药物方面有较大增长.
- 评估实施干预措施对用于烟草治疗的药物处方的影响.
主要方法:
- 一项为期四年的实施试验分析了洛杉矶县18家社区诊所 (初级保健和心理健康) 的戒烟药物治疗的全诊所处方数据.
- 专业服务包括行为咨询和烟草治疗药物. 随着时间的推移,干预组 (特殊服务与通常治疗) 之间的处方率进行了比较.
主要成果:
- 在试验期间,所有参与诊所都显示戒烟药物处方增加.
- 随机分配为提供专业TUD服务的诊所显示,与通常提供治疗的诊所相比,尼古丁贴片,口香糖和瓦雷尼克林的处方率显著增加.
- 这一效应在初级保健 (P = 0.020) 和心理健康环境 (P = 0.004) 中都具有统计学意义.
结论:
- 促进戒烟药物的处方的基于社区的实施干预措施是有效的.
- 这些干预措施有可能减少人口中不成比例地受到TUD及其后果影响的健康差异.
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