Subsidized pharmacological treatment for smoking cessation by the Spanish public health system: A randomized, pragmatic, clinical trial by clusters
| Autor: | Encarnación Serrano-Serrano, Francisco Camarelles-Guillem, César Minué-Lorenzo, Jose M. Vizcaíno-Sánchez, M. Isabel Gámez-Cabero, José A. Granados-Garrido, F. Javier Martínez-Suberviola, Eduardo Olano-Espinosa, Margarita Ruiz-Pacheco, Isabel del Cura-González |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Health (social science) Randomization medicine.medical_treatment media_common.quotation_subject Medicine (miscellaneous) lcsh:RC254-282 03 medical and health sciences 0302 clinical medicine Pharmacotherapy healthcare financing Internal medicine Health care medicine 030212 general & internal medicine media_common lcsh:RC705-779 030505 public health business.industry Public health Public Health Environmental and Occupational Health lcsh:Diseases of the respiratory system Abstinence lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens smoking cessation drug therapy primary health care Clinical trial Spain Smoking cessation Private healthcare 0305 other medical science business Research Paper |
| Zdroj: | Tobacco Induced Diseases, Vol 17, Iss September (2019) Tobacco Induced Diseases |
| ISSN: | 1617-9625 |
| DOI: | 10.18332/tid/111368 |
| Popis: | Introduction Research has shown that financing drug therapy increases smoking abstinence rates, although most of these studies have been carried out in the private healthcare setting. The aim of this work is to assess the effect of subsidized pharmacological treatment on smoking cessation rates by the Spanish public healthcare system. Methods A pragmatic, randomized, clinical trial was performed by clusters. Randomization unit was the primary healthcare center and the analysis unit was the patient. Smokers consuming ≥10 cigarettes/day were randomly assigned to an intervention group that received financed pharmacological treatment or to a control group that followed usual care. The main outcome was self-reported or CO-confirmed continuous abstinence at 12 months. The main outcome, continuous abstinence rates (%), were compared between groups at 12 months post-intervention. A model was adjusted using mixed-effect logistic regression. Results A total of 1154 patients were included from 23 healthcare centers. In the intention-to-treat analysis, self-reported abstinence after 12 months in the control and intervention groups, respectively, was 9.6% (37/387) and 15.4% (118/767) (gender-adjusted OR=1.75; 95% CI: 1.1-2.8); for CO-confirmed abstinence the corresponding values were 3.1% (12/387) and 6.4% (49/767) (gender-adjusted OR=1.72; 95% CI: 0.7-4.0). Pharmacological treatment use was 35.1% (136/387) in the control group, and 58.3% (447/767) in the intervention group (adjusted OR=4.25; 95% CI: 1.8-9.9). Conclusions Subsidizing pharmacological treatment for smoking cessation increases self-reported or CO-confirmed abstinence rates under realistic conditions in the primary care setting of the Spanish public health system. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|