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http://hdl.handle.net/2445/196502
Title: | Effectiveness of multicomponent interventions in primary healthcare settings to promote continuous smoking cessation in adults: a systematic review |
Author: | Martín-Cantera, Carlos Puigdomènech, Elisa Ballvé Moreno, José Luis Arias-Agudelo, Olga Lucia Clemente, Lourdes Casas, Ramon Roig, Lydia Pérez-Tortosa, Santiago Díaz-Gete, Laura Granollers Mercader, Sílvia |
Keywords: | Atenció primària Promoció de la salut Tractament del tabaquisme Adults Primary care Health promotion Smoking cessation Adulthood |
Issue Date: | 1-Oct-2015 |
Publisher: | BMJ Publishing Group |
Abstract: | Objective: The objective of the present review is to evaluate multicomponent/complex primary care (PC) interventions for their effectiveness in continuous smoking abstinence by adult smokers. Design: A systematic review of randomised and non-randomised controlled trials was undertaken. Eligibility criteria for included studies: Selected studies met the following criteria: evaluated effects of a multicomponent/complex intervention (with 2 or more intervention components) in achieving at least 6-month abstinence in adult smokers who visited a PC, biochemical confirmation of abstinence, intention-to-treat analysis and results published in English/Spanish. Methods: We followed PRISMA statement to report the review. We searched the following data sources: MEDLINE, Web of Science, Scopus (from inception to February 2014), 3 key journals and a tobacco research bulletin. The Scottish Intercollegiate Guidelines Network checklists were used to evaluate methodological quality. Data selection, evaluation and extraction were done independently, using a paired review approach. Owing to the heterogeneity of interventions in the studies included, a meta-analysis was not conducted. Results: Of 1147 references identified, 9 studies were selected (10,204 participants, up to 48 months of follow-up, acceptable methodological quality). Methodologies used were mainly individual or group sessions, telephone conversations, brochures or quit-smoking kits, medications and economic incentives for doctors and no-cost medications for smokers. Complex interventions achieved long-term continuous abstinence ranging from 7% to 40%. Behavioural interventions were effective and had a dose-response effect. Both nicotine replacement and bupropion therapy were safe and effective, with no observed differences. Conclusions: Multicomponent/complex interventions in PC are effective and safe, appearing to achieve greater long-term continuous smoking cessation than usual care and counselling alone. Selected studies were heterogeneous and some had significant losses to follow-up. Our results show that smoking interventions should include more than one component and a strong follow-up of the patient to maximise results. |
Note: | Reproducció del document publicat a: https://doi.org/10.1136/bmjopen-2015-008807 |
It is part of: | BMJ Open, 2015, vol. 5, num. 10 |
URI: | http://hdl.handle.net/2445/196502 |
Related resource: | https://doi.org/10.1136/bmjopen-2015-008807 |
ISSN: | 2044-6055 |
Appears in Collections: | Articles publicats en revistes (Ciències Clíniques) |
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