在多发性硬化症退伍军人中戒烟查和治疗
Carri S Polick1,2, Catherine A Sims1,3, Samantha Meckes1,4
1Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Healthcare System, Durham, NC 27705, United States.
Military medicine
|April 9, 2025
概括
退伍军人患有多发性硬化症 (VwMS) 的戒烟查和治疗率较低. 观察到护理方面的差异,特别是在妇女和少数民族退伍军人方面,强调需要改进干预措施.
科学领域:
- 公共卫生 公共卫生
- 改善临床质量 改善临床质量
- 医疗保健服务研究 医疗服务研究
背景情况:
- 吸烟是可预防死亡的主要原因,不成比例地影响退伍军人.
- 吸烟加剧了多发性硬化症 (MS) 的进展,增加了MS (VwMS) 的退伍军人的复发,残疾和死亡率.
- 有效的戒烟干预措施对于VwMS来说至关重要,以改善健康结果和疾病管理.
研究的目的:
- 描述VA医院内VwMS目前的戒烟查和治疗实践.
- 探索在向VwMS提供戒烟护理方面的潜在社会人口差异.
- 确定改善VwMS的戒烟支持的差距和机会.
主要方法:
- 一个质量改进项目,利用一个经过验证的算法来识别在2020-2022财年期间吸烟的VwMS.
- 以"实施研究综合框架"为指导的回顾性图表审查,并进行可靠性审计.
- 对群体内部比例的分析,以比较跨社会人口统计因素的护理接收情况.
主要成果:
- 由于目前缺乏查,只有58%的确定的VwMS吸烟者有资格进行分析,这表明有很大的护理差距.
- 虽然大多数接受查的VwMS接受了行为和药物干预的报价,但对戒烟诊所的兴趣和转诊率很低.
- 发现了差异,女性和少数民族退伍军人不太可能被评估吸烟状态,并提供戒烟策略.
结论:
- 在VwMS中观察到戒烟查,治疗兴趣和分娩率较低.
- 在护理方面存在显著的种族和性别差异表明,在戒烟支持方面存在系统性不平等.
- 障碍包括EHR转诊物流,意识,耻辱和分散的护理;需要进一步研究涉及VwMS和临床医生.
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