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首页> 外文期刊>Journal of general internal medicine >Impact of Adding Telephone-Based Care Coordination to Standard Telephone-Based Smoking Cessation Counseling Post-hospital Discharge: a Randomized Controlled Trial
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Impact of Adding Telephone-Based Care Coordination to Standard Telephone-Based Smoking Cessation Counseling Post-hospital Discharge: a Randomized Controlled Trial

机译：将基于电话的护理协调加入标准电话的戒烟咨询后医院后咨询的影响：随机对照试验

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Background Cessation counseling and pharmacotherapy are recommended for hospitalized smokers, but better coordination between cessation counselors and providers might improve utilization of pharmacotherapy and enhance smoking cessation. Objective To compare smoking cessation counseling combined with care coordination post-hospitalization to counseling alone on uptake of pharmacotherapy and smoking cessation. Design Unblinded, randomized clinical trial Participants Hospitalized smokers referred from primarily rural hospitals Interventions Counseling only (C) consisted of telephone counseling provided during the hospitalization and post-discharge. Counseling with care coordination (CCC) provided similar counseling supplemented by feedback to the smoker's health care team and help for the smoker in obtaining pharmacotherapy. At 6 months post-hospitalization, persistent smokers were re-engaged with either CCC or C. Main Measures Utilization of pharmacotherapy and smoking cessation at 3, 6, and 12 months post-discharge. Key Results Among 606 smokers randomized, 429 (70.8%) completed the 12-month assessment and 580 (95.7%) were included in the primary analysis. Use of any cessation pharmacotherapy between 0 and 6 months (55.2%) and between 6 and 12 months (47.1%) post-discharge was similar across treatment arms though use of prescription-only pharmacotherapy between months 6-12 was significantly higher in the CCC group (30.1%) compared with the C group (18.6%) (RR, 1.61 (95% CI, 1.08, 2.41)). Self-reported abstinence rates of 26.2%, 20.3%, and 23.4% at months 3, 6, and 12, respectively, were comparable across the two treatment arms. Of those smoking at month 6, 12.5% reported abstinence at month 12. Validated smoking cessation at 12 months was 19.3% versus 16.9% in the CCC and C groups, respectively (RR, 1.13 (95% CI, 0.80, 1.61)). Conclusion Supplemental care coordination, provided by counselors outside of the health care team, failed to improve smoking cessation beyond that achieved by cessation counseling alone. Re-engagement of smokers 6 months post-discharge can lead to new quitters, at which time care coordination might facilitate use of prescription medications.
机译：建议停养咨询和药物治疗住院吸烟者，但停止辅导员和提供商之间的更好协调可能会改善药物治疗的利用率，增强吸烟。目的了解吸烟咨询，结合护理协调后住院治疗，仅用于咨询药物治疗和吸烟停止。设计未粘连，随机临床试验参与者入住的吸烟者主要从农村医院的干预措施咨询（c）包括在住院期间提供的电话咨询和出院后。咨询与护理协调（CCC）提供了类似的咨询，并通过反馈给吸烟者的医疗保健团队提供了类似的咨询，并帮助吸烟者获得药物治疗。在住院后6个月，持久吸烟者与CCC或C重新啮合。主要措施在出院后3,6和12个月的药物治疗和吸烟停止。 606名吸烟者随机化的关键结果完成了429（70.8％）完成了12个月的评估，580名（95.7％）纳入主要分析。使用任何戒液药物治疗0到6个月（55.2％）和6至12个月（47.1％）在出院后相似，虽然在CCC之间的处方6-12之间的药物治疗显着高于几个月的药物治疗与C组（18.6％）（RR，1.61（95％CI，1.08,2.41）相比，组（30.1％）。在几个治疗臂中分别在3,6和12个分别的自我报告的禁欲率为26.2％，20.3％和23.4％。在6月6日的那些吸烟中，12.5％报告的戒烟时间为12月12日。分别在12个月内验证的戒烟与CCC和C组的16.3％（RR，1.13（95％CI，0.80,1.61））。结论卫生保健团队以外的辅导员提供的补充护理协调未能改善独自停止咨询所取得的吸烟。放电后6个月的吸烟者可以导致新的戒烟者，此时时间护理协调可能有助于使用处方药物。

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