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首页> 外文期刊>BMC Family Practice >Quit in General Practice: a cluster randomised trial of enhanced in-practice support for smoking cessation
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Quit in General Practice: a cluster randomised trial of enhanced in-practice support for smoking cessation

机译：退出一般实践：为戒烟提供更多实践支持的集群随机试验

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Background This study will test the uptake and effectiveness of a flexible package of smoking cessation support provided primarily by the practice nurse (PN) and tailored to meet the needs of a diversity of patients. Methods/Design This study is a cluster randomised trial, with practices allocated to one of three groups 1) Quit with Practice Nurse 2) Quitline referral 3) GP usual care. PNs from practices randomised to the intervention group will receive a training course in smoking cessation followed by access to mentoring. GPs from practices randomised to the Quitline referral group will receive information about the study and the process of written referral and GPs in the usual care group will receive information about the study. Eligible patients are those aged 18 and over presenting to their GP who are daily or weekly smokers and who are able to give informed consent. Patients on low incomes in all three groups will be able to access free nicotine patches. Primary outcomes are sustained abstinence and point prevalence abstinence at the three month and 12 month follow-up points; and incremental cost effectiveness ratios at 12 months. Process evaluation on the reach and acceptability of the intervention approached will be collected through Computer Assisted Telephone Interviews (CATI) with patients and semi-structured interviews with PNs and GPs. The primary analysis will be by intention to treat. Cessation outcomes will be compared between the three arms at three months and 12 month follow-up using multiple logistic regression. The incremental cost effectiveness ratios will be estimated for the 12 month quit rate for the intervention groups compared to usual care and to each other. Analysis of qualitative data on process outcomes will be based on thematic analysis. Discussion High quality evidence on effectiveness of practice nurse interventions is needed to inform health policy on development of practice nurse roles. If effective, flexible support from the PN in partnership with the GP and the Quitline could become the preferred model for providing smoking cessation advice in Australian general practice. Trial Registration ACTRN12609001040257
机译：背景信息本研究将测试主要由执业护士（PN）提供并针对各种患者的需求量身定制的灵活的戒烟支持服务的吸收和效果。方法/设计本研究是一项整群随机试验，其实践分配为三组之一：1）与实践护士一起戒烟2）Quitline转诊3）GP常规护理。随机分配给干预组的实践者将接受戒烟培训课程，然后接受指导。从随机分配到Quitline转诊组的实践中的全科医生将获得有关该研究和书面转诊过程的信息，而普通护理组中的GP将获得有关该研究的信息。符合条件的患者是那些每天或每周吸烟且能够在知情同意下向GP求诊的18岁及以上的患者。所有这三个组的低收入患者都将能够获得免费的尼古丁贴片。主要结局是在三个月和十二个月的随访中持续禁欲和点流行性禁欲;和12个月时的增量成本效益比。将通过对患者的计算机辅助电话访谈（CATI）以及对PN和GP的半结构化访谈，收集有关所采取干预措施的覆盖范围和可接受性的过程评估。主要分析将按意向进行。在三个月和十二个月的随访中，将使用多元逻辑回归比较三个部门之间的戒断结局。与常规护理和彼此护理相比，将为干预组的12个月戒烟率估算增加的成本效益比。有关过程结果的定性数据分析将基于主题分析。讨论需要有关执业护士干预效果的高质量证据，以向健康政策提供有关执业护士角色发展的信息。如果有效，PN将与GP和Quitline合作提供灵活的支持，将成为澳大利亚一般实践中提供戒烟建议的首选模式。试用注册ACTRN12609001040257

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