Outil d’aide à la décision comparant les traitements pharmacologiques pour l’arrêt du tabac

Jakob, Julian; Cornuz, Jacques; Auer, Reto; Sadowski, Isabelle Jacot; Cardinaux, Regula; Selby, Kevin

doi:10.53738/revmed.2017.13.566.1191

Cited by 4 publications

(4 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The decision aid will be available in both paper and electronic formats based on our previously developed one-page table (Appendix 4 ) [ 18 ]. It is an encounter DA, designed for use during consultations.…”

Section: Methods and Designmentioning

confidence: 99%

See 1 more Smart Citation

Combining default choices and an encounter decision aid to improve tobacco cessation in primary care patients: protocol for a cluster-randomized trial

et al. 2022

Self Cite

View full text Add to dashboard Cite

Background While quitting smoking dramatically decreases overall mortality, general practitioners (GPs) are less likely to prescribe medications for smoking cessation than other cardiovascular risk factors. Guidelines recommend providers first assess patients’ “readiness” to quit, an “opt-in” strategy, but only a minority of tobacco users are ready to quit on a given day. An “opt-out” strategy offering treatment as the default choice increased quit attempts in hospital and with pregnant women, but has not been tested in primary care. We will assess the efficacy of training GPs to offer treatment as the default choice using an encounter decision aid with current smokers seen in primary care. Methods This is a pragmatic cluster-randomized controlled superiority trial with block randomization at the GP level in private practice in French-speaking Switzerland. GPs will be blinded to the arm allocation. The intervention is a half-day training course teaching an ‘opt-out’ approach to smoking cessation using an encounter decision aid (paper or electronic). GPs in the enhanced usual care group receives a brief refresher training about smoking cessation without changing their behaviour. GPs in both arms will recruit 23 patients each prior to routine primary care visits. The primary outcome is the effect of consulting a GP who received the intervention on the 7-day, point prevalence, smoking abstinence 6 months after the baseline appointment. Secondary outcomes include continuous abstinence; number of quit attempts; use of smoking cessation aids; patient-perceived involvement in discussions; and changes in GP behaviour. Patient outcomes will be collected using paper and telephone questionnaires. Assuming 15% drop-out, recruiting 46 GPs with 23 patients each will give us 80% power to detect an increase in smoking cessation from 4% (control) to 10.5% (intervention), with an alpha < 0.05. Discussion GP visits are an opportunity to administer proven smoking cessation treatments. We hypothesize GPs offering smoking cessation treatment as the default choice using an encounter decision aid will increase the number of patients who quit. This study could significantly change our approach to smoking cessation in primary care. Default choices and the electronic decision aid are low-cost, easily diffusible interventions. Trial registration ClinicalTrials.gov Identifier: NCT04868474, First Posted May 3, 2021, Last Update Posted October 6, 2021.

show abstract

Section: Methods and Designmentioning

confidence: 99%

“…The DA was designed to be accessible, intuitive and easy to use. During the consultation, this tool will support GPs in prescribing and help patients chose a pharmacological treatment [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

Combining default choices and an encounter decision aid to improve tobacco cessation in primary care patients: protocol for a cluster-randomized trial

et al. 2022

Self Cite

View full text Add to dashboard Cite

show abstract

“…Study nurses provided SOC smoking cessation counseling based on cognitive behavior therapy, motivational interviewing, and shared decision-making for smoking cessation drug support, including NRT and smoking cessation recommendations adapted to nicotine dependence (Supplementary Appendix). 12,13 Participants were counseled in-person at the baseline visit and by phone at TQD and Weeks 1, 2, 4, and 8 after TQD. Participants allocated to SOC received CHF 50 (50 USD) vouchers at the baseline visit for the purchase of NRT.…”

Section: Control Group (Soc Only)mentioning

confidence: 99%

Electronic Nicotine-Delivery Systems for Smoking Cessation

2024

N Engl J Med

View full text Add to dashboard Cite

Background: Electronic nicotine delivery systems (ENDS) are used by some tobacco smokers to assist with quitting. Evidence regarding the efficacy and safety of ENDS use for tobacco smoking cessation are needed. Methods:In this open-label, controlled trial, we randomized adult smokers of at least 5 tobacco cigarettes/day and willing to set a quit date to an intervention involving provision of free ENDS and e-liquids in addition to standard-of-care smoking cessation counseling (SOC) including the optional use of nicotine replacement therapy (NRT), or to control. The control group received SOC and a voucher for the optional purchase of NRT. The primary outcome was biochemically validated, continuous self-reported tobacco cigarette smoking abstinence at 6-months. Secondary outcomes included participant-reported abstinence from tobacco and from any nicotine (including smoking, e-cigarettes, and nicotine-replacement therapy) at 6 months, respiratory symptoms, and serious adverse events.Results: We randomized 1246 participants. Validated continuous abstinence rate from tobacco smoking was 28.9% in the intervention group and 16.3% in the control group (RR:1.77;95% confidence interval: 1.43 to 2.20). Abstinence from tobacco smoking in the 7 days prior to the 6-months visit was 59.6% in the intervention group vs 38.5% in the control group, but abstinence from nicotine use (through tobacco smoking, ENDS or NRT use) was 20.1% in the intervention group and 33.7% in the control group. SAEs occurred in 25 (4%) and 31 (5%) of the intervention and control group participants, respectively; AEs in 272 (43.7%) and 229 (36.7%). Conclusion:The addition of ENDS to SOC counseling increased abstinence from tobacco among smokers more than SOC alone.

show abstract

“…Ce taux est doublé, voire triplé, avec l'utilisation des aides à l'arrêt, notamment des remplacements nicotiniques, des médicaments (varénicline ou bupropion) ou de la vaporette. 3 Des études observationnelles de consultations démontrent que les médecins abordent le tabagisme avec deux tiers de leurs patient-e-s fumeur-euse-s, recommandent l'arrêt à un tiers d'entre eux et prescrivent une aide à l'arrêt dans moins de 20 % des cas. 4 Parmi les raisons de la sous-utilisation des aides à l'arrêt, côté patient-e, on note un manque de connaissances sur la disponibilité des traitements et leur efficacité et une surestimation de leurs effets secondaires.…”

Section: Introductionunclassified

Outils d’aide à la décision dans les addictions : ľexemple du tabac

Schneiter

Habfast-Robertson

Adam

et al. 2022

Revue Médicale Suisse

View full text Add to dashboard Cite

Les outils d'aide à la décision (AD) soutiennent les patient-e-s dans leurs choix médicaux en majorant leurs connaissances et en clarifiant leurs valeurs et préférences, ce qui leur permet de s'impliquer dans le processus décisionnel. Les AD existent en tant que supports physiques (papier, DVD) ou informatiques. Ils peuvent être utilisés par les patient-e-s avant/après la consultation ou avec le-la professionnel-le de santé durant la consultation. Unisanté a créé un AD présentant les aides à l'arrêt du tabac durant la consultation. Une étude locale a montré que l'usage de celui-ci a été jugé simple et utile par les médecins. L'utilisation d'AD dans les addictions à d'autres substances, renforcée par des entretiens de décision partagée, montre un effet favorable sur l'implication des patient-e-s et sur l'adhésion thérapeutique. Decision aids for addictions: the example of smoking cessationDecision aids (DAs) help patients participate in healthcare decisions by improving knowledge and clarifying values and preferences, thus favoring a more active role in the decision process. DAs exist as a physical support (paper, DVD, audio) or computerized formats.They can be used independently by patients before and after consultations, or with a health professional during consultations. Unisanté has created a DA for use during consultations presenting available smoking cessation aids (www.howtoquit.ch). A local study showed that the DA is considered easy to use and useful by the doctors interviewed. The use of DAs in addictions to other substances, in conjunction with shared decision making, shows a favourable effect on the involvement of patients in their health and therapeutic adherence.

show abstract

Outil d’aide à la décision comparant les traitements pharmacologiques pour l’arrêt du tabac

Cited by 4 publications

References 0 publications

Combining default choices and an encounter decision aid to improve tobacco cessation in primary care patients: protocol for a cluster-randomized trial

Combining default choices and an encounter decision aid to improve tobacco cessation in primary care patients: protocol for a cluster-randomized trial

Electronic Nicotine-Delivery Systems for Smoking Cessation

Outils d’aide à la décision dans les addictions : ľexemple du tabac

Contact Info

Product

Resources

About