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Effectiveness of multicomponent interventions in primary healthcare settings to promote continuous smoking cessation in adults: a systematic review
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 C...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4606220/ https://www.ncbi.nlm.nih.gov/pubmed/26428333 http://dx.doi.org/10.1136/bmjopen-2015-008807 |
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author | Martín Cantera, Carlos Puigdomènech, Elisa Ballvé, Jose Luis Arias, Olga Lucía Clemente, Lourdes Casas, Ramon Roig, Lydia Pérez-Tortosa, Santiago Díaz-Gete, Laura Granollers, Sílvia |
author_facet | Martín Cantera, Carlos Puigdomènech, Elisa Ballvé, Jose Luis Arias, Olga Lucía Clemente, Lourdes Casas, Ramon Roig, Lydia Pérez-Tortosa, Santiago Díaz-Gete, Laura Granollers, Sílvia |
author_sort | Martín Cantera, Carlos |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-4606220 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-46062202015-10-22 Effectiveness of multicomponent interventions in primary healthcare settings to promote continuous smoking cessation in adults: a systematic review Martín Cantera, Carlos Puigdomènech, Elisa Ballvé, Jose Luis Arias, Olga Lucía Clemente, Lourdes Casas, Ramon Roig, Lydia Pérez-Tortosa, Santiago Díaz-Gete, Laura Granollers, Sílvia BMJ Open Smoking and Tobacco 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. BMJ Publishing Group 2015-10-01 /pmc/articles/PMC4606220/ /pubmed/26428333 http://dx.doi.org/10.1136/bmjopen-2015-008807 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ |
spellingShingle | Smoking and Tobacco Martín Cantera, Carlos Puigdomènech, Elisa Ballvé, Jose Luis Arias, Olga Lucía Clemente, Lourdes Casas, Ramon Roig, Lydia Pérez-Tortosa, Santiago Díaz-Gete, Laura Granollers, Sílvia Effectiveness of multicomponent interventions in primary healthcare settings to promote continuous smoking cessation in adults: a systematic review |
title | Effectiveness of multicomponent interventions in primary healthcare settings to promote continuous smoking cessation in adults: a systematic review |
title_full | Effectiveness of multicomponent interventions in primary healthcare settings to promote continuous smoking cessation in adults: a systematic review |
title_fullStr | Effectiveness of multicomponent interventions in primary healthcare settings to promote continuous smoking cessation in adults: a systematic review |
title_full_unstemmed | Effectiveness of multicomponent interventions in primary healthcare settings to promote continuous smoking cessation in adults: a systematic review |
title_short | Effectiveness of multicomponent interventions in primary healthcare settings to promote continuous smoking cessation in adults: a systematic review |
title_sort | effectiveness of multicomponent interventions in primary healthcare settings to promote continuous smoking cessation in adults: a systematic review |
topic | Smoking and Tobacco |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4606220/ https://www.ncbi.nlm.nih.gov/pubmed/26428333 http://dx.doi.org/10.1136/bmjopen-2015-008807 |
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