Initiating Pharmacologic Treatment in Tobacco-Dependent Adults. An Official American Thoracic Society Clinical Practice Guideline
| Autor: | Panagis Galiatsatos, Dona Upson, Kelly K O'Brien, Hasmeena Kathuria, A. Eden Evins, Smita Pakhale, Luciane Cruz-Lopes, David P.L. Sachs, Dan Xiao, Manuel C Pacheco, Benjamin A. Toll, Kathleen Fennig, Stephen P. Kantrow, Thomas Lamphere, Patricia Folan, Frank T. Leone, Michelle N. Eakin, Izabela Fulone, Sarah Evers-Casey, Sureka Pavalagantharajah, Meng Zhu, Stephanie Ross, Yuan Zhang, Rachael L Murray, Harold J. Farber, David J. Prezant, Hyma Gogineni, Joelle T. Fathi, Enid Neptune, Yuqing Zhang |
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| Rok vydání: | 2020 |
| Předmět: |
Pulmonary and Respiratory Medicine
Adult Male medicine.medical_specialty Nicotine patch medicine.medical_treatment Psychological intervention Critical Care and Intensive Care Medicine tobacco smoking 03 medical and health sciences chemistry.chemical_compound pharmacotherapy 0302 clinical medicine Pharmacotherapy medicine Humans 030212 general & internal medicine Varenicline Bupropion Aged Aged 80 and over American Thoracic Society Documents Smoking Cessation Agents treatment business.industry Guideline Tobacco Use Disorder dependence Middle Aged United States Systematic review 030228 respiratory system chemistry Family medicine Practice Guidelines as Topic Smoking cessation Female business medicine.drug |
| Zdroj: | American Journal of Respiratory and Critical Care Medicine |
| ISSN: | 1535-4970 |
| Popis: | Background: Current tobacco treatment guidelines have established the efficacy of available interventions, but they do not provide detailed guidance for common implementation questions frequently faced in the clinic. An evidence-based guideline was created that addresses several pharmacotherapy-initiation questions that routinely confront treatment teams. Methods: Individuals with diverse expertise related to smoking cessation were empaneled to prioritize questions and outcomes important to clinicians. An evidence-synthesis team conducted systematic reviews, which informed recommendations to answer the questions. The GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach was used to rate the certainty in the estimated effects and the strength of recommendations. Results: The guideline panel formulated five strong recommendations and two conditional recommendations regarding pharmacotherapy choices. Strong recommendations include using varenicline rather than a nicotine patch, using varenicline rather than bupropion, using varenicline rather than a nicotine patch in adults with a comorbid psychiatric condition, initiating varenicline in adults even if they are unready to quit, and using controller therapy for an extended treatment duration greater than 12 weeks. Conditional recommendations include combining a nicotine patch with varenicline rather than using varenicline alone and using varenicline rather than electronic cigarettes. Conclusions: Seven recommendations are provided, which represent simple practice changes that are likely to increase the effectiveness of tobacco-dependence pharmacotherapy. |
| Databáze: | OpenAIRE |
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