A Narrative Review of Intensive Group Tobacco Treatment: Clinical, Research, and US Policy Recommendations.

Autor:	Kotsen C; Tobacco Quitcenter, Lung Cancer Institute, Steeplechase Cancer Center, RWJ Barnabas Health, Robert Wood Johnson Barnabas Health University Hospital Somerset, Somerville, NJ., Santorelli ML; Community Health and Wellness Unit, New Jersey Department of Health, State of New Jersey, Trenton, NJ., Bloom EL; Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI.; Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI.; Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI., Goldstein AO; Tobacco Intervention Programs, Department of Family Medicine, University of North Carolina, Chapel Hill, NC., Ripley-Moffitt C; Nicotine Dependence Program, Department of Family Medicine, University of North Carolina, Chapel Hill, NC., Steinberg MB; Rutgers Tobacco Dependence Program, Division of General Internal Medicine, Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ., Burke MV; Nicotine Dependence Center, Mayo Clinic, Rochester, MN., Foulds J; Population Health and Cancer Control Program, Cancer Institute, College of Medicine, Penn State University, Hershey, PA.
Jazyk:	angličtina
Zdroj:	Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco [Nicotine Tob Res] 2019 Nov 19; Vol. 21 (12), pp. 1580-1589.
DOI:	10.1093/ntr/nty162
Abstrakt:	Introduction: Clinical practice guidelines recommend comprehensive treatment for tobacco dependence including pharmacotherapies and behavioral interventions. Group counseling may deliver unique treatment aspects not available with other modalities. This manuscript provides a narrative review of group treatment outcomes from real-world practice settings and complements recent meta-analyses of randomized controlled trials (RCTs). Our primary goals were to determine whether group treatments delivered in these settings have yielded similar quit rates compared to individual treatment and to provide recommendations for best practices and policy. Methods: Group treatment was defined as occurring in a clinical or workplace setting (ie, not provided as part of a research study), led by a professionally trained clinician, and offered weekly over several weeks. English language PubMed articles from January 2000 to July 2017 were searched to identify studies that included outcomes from both group and individual treatment offered in real-world settings. Additional data sources meeting our criteria were also included. Reports not using pharmacotherapy and research studies (eg, RCTs) were excluded. The primary outcome was short-term, carbon monoxide (CO)-validated point prevalence abstinence (4-week postquit date). Results: The review included data from 11 observational studies. In all cases, group treatment(s) had higher 4-week CO-validated quit rates (range: 35.5%-67.3%) than individual treatment(s) (range: 18.6%-53.3%). Conclusions: Best practice group treatments for tobacco dependence are generalizable from research to clinical settings and likely to be at least as effective as intensive individual treatment. The added advantages of efficiency and cost-effectiveness can be significant. Group treatment is feasible in various settings with good results. Implications: A major barrier to achieving high rates of tobacco abstinence is under-utilization of evidence-based treatment interventions. This review demonstrates the effectiveness and utility of group treatment for tobacco dependence. Based on the available data described in this narrative review in conjunction with existing RCT data, group treatment for tobacco dependence should be established and available in all behavioral health and medical settings. Group tobacco treatment is now one of the mandated reimbursable tobacco treatment formats within the US health care system, creating enormous opportunities for widespread clinical reach. Finally, comprehensive worksite group programs can further extend impact. (© The Author(s) 2018. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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