Effectiveness of multicomponent interventions in primary healthcare settings to promote continuous smoking cessation in adults : a systematic review
Martín-Cantera, Carlos (Universitat Autònoma de Barcelona. Departament de Medicina)
Puigdomènech, Elisa (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Ballve Moreno, José Luis (Institut Català de la Salut. Centre d'Atenció Primària Florida Nord)
Arias Agudelo, Olga Lucia (Institut Català de la Salut. Centre d'Atenció Primària Florida Nord)
Clemente, Lourdes (Centro de Salud Santo Grial (Osca, Aragó))
Casas, Ramón (Institut Català de la Salut. Centre d'Atenció Primària Sant Antoni)
Roig, Lydia (Institut Català de la Salut. Centre d'Atenció Primària La Garriga)
Perez Tortosa, Santiago (Institut Català de la Salut. Centre d'Atenció Primària La Llagosta)
Díaz-Gete, Laura (Institut Català de la Salut. Centre d'Atenció Primària La Sagrera)
Granollers, Sílvia (Institut Català de la Salut. Centre d'Atenció Primària Esplugues de Llobregat)

Data:	2015
Resum:	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.
Ajuts:	Instituto de Salud Carlos III PI12/01914
Nota:	Altres ajuts: Red de Investigación en Actividades Preventivas y Promoción de la Salud (redIAPP, RD12/0005)
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Primary care ; Health promotion ; Smoking cessation ; Systematic review
Publicat a:	BMJ open, Vol. 5, No. 10 (2015) , p. e008807, ISSN 2044-6055

DOI: 10.1136/bmjopen-2015-008807
PMID: 26428333

17 p, 1.5 MB

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