住院吸烟者戒烟：对“渥太华模式”的评估
2010/02/23
前言：对住院吸烟者进行干预能增加长期戒烟率。渥太华戒烟模式采用“5A”法戒烟，常用于住院的吸烟患者。本研究旨在安大略省东部9个医院评价渥太华模式实施的有效性。
方法：RE-AIM 体系（传递、效能、采用、实施和维持）用于评价此项干预措施。经过培训的工作人员进入9所医院实施渥太华模式。采用管理数据及随访数据对项目的实施进行为期一年的监控。对接受渥太华模型的住院吸烟患者6个月后的戒断率进行检测。自我主诉的戒断通过对患者抽样采用生化检测方法验证。所有戒断率经潜在虚报校正。
结果：69％吸烟患者接受渥太华模式干预。校正医院差异后，引入渥太华模式后的6个月持续阶段率较之前显著增加（29.4% vs.18.3%; OR= 1.71, 95% CI = 1.11-2.64; Z = 2.43; I(2) = 0%;P = .02）。引入渥太华模式干预较处方药物或出院后随访更有可能完成对吸烟者的咨询。项目实施过程中存在着态度、管理及环境方面的影响。
讨论：经过培训的工作人员成功在9所医院采用渥太华模式进行戒烟干预。结果显示长期戒断率显著增加。该研究对于住院吸烟者的系统性戒烟具有重要影响。
（陈欣 审校）
Nicotine Tob Res. 2009 Nov 10. [Epub ahead of print]
Smoking cessation for hospitalized smokers: An evaluation of the "Ottawa Model"
Reid RD, Mullen KA, Slovinec D’Angelo ME, Aitken DA, Papadakis S, Haley PM, McLaughlin CA, Pipe AL.
INTRODUCTION: Interventions for hospitalized smokers can increase long-term smoking cessation rates. The Ottawa Model for Smoking Cessation (the "Ottawa Model") is an application of the "5 A’s" approach to cessation, customized to the hospital setting. This study evaluated the impact of implementing the Ottawa Model in 9 hospitals in eastern Ontario.
METHODS: The RE-AIM (Reach, Efficacy, Adoption, Implementation, and Maintenance) framework was used to evaluate the intervention. Trained outreach facilitators assisted 9 hospitals to implement the Ottawa Model; program delivery was then monitored over a 1-year period using administrative data and data from a follow-up database. A before-and-after study was conducted to gauge the effect of the Ottawa Model program on cessation rates 6 months after hospitalization. Self-reports of smoking cessation were biochemically confirmed in a random sample of patients, and all cessation rates were corrected for potential misreporting.
RESULTS: Sixty-nine percent of the expected number of smokers received the Ottawa Model intervention. Controlling for hospital, the confirmed 6-month continuous abstinence rate was higher after, than before, introduction of the Ottawa Model (29.4% vs. 18.3%; odds ratio = 1.71, 95% CI = 1.11-2.64; Z = 2.43; I(2) = 0%; p = .02). The intervention was more likely to accomplish counseling for smokers than delivery of medications or postdischarge follow-up. Attitudinal, managerial, and environmental challenges to program implementation were identified.
DISCUSSION: Trained outreach facilitators successfully implemented the Ottawa Model in 9 hospitals leading to significantly higher long-term cessation rates. The public health implications of systematic cessation programs for hospitalized smokers are profound.
Reid RD, Mullen KA, Slovinec D’Angelo ME, et al. Nicotine Tob Res. 2009 Nov 10. [Epub ahead of print]
方法：RE-AIM 体系（传递、效能、采用、实施和维持）用于评价此项干预措施。经过培训的工作人员进入9所医院实施渥太华模式。采用管理数据及随访数据对项目的实施进行为期一年的监控。对接受渥太华模型的住院吸烟患者6个月后的戒断率进行检测。自我主诉的戒断通过对患者抽样采用生化检测方法验证。所有戒断率经潜在虚报校正。
结果：69％吸烟患者接受渥太华模式干预。校正医院差异后，引入渥太华模式后的6个月持续阶段率较之前显著增加（29.4% vs.18.3%; OR= 1.71, 95% CI = 1.11-2.64; Z = 2.43; I(2) = 0%;P = .02）。引入渥太华模式干预较处方药物或出院后随访更有可能完成对吸烟者的咨询。项目实施过程中存在着态度、管理及环境方面的影响。
讨论：经过培训的工作人员成功在9所医院采用渥太华模式进行戒烟干预。结果显示长期戒断率显著增加。该研究对于住院吸烟者的系统性戒烟具有重要影响。
（陈欣 审校）
Nicotine Tob Res. 2009 Nov 10. [Epub ahead of print]
Smoking cessation for hospitalized smokers: An evaluation of the "Ottawa Model"
Reid RD, Mullen KA, Slovinec D’Angelo ME, Aitken DA, Papadakis S, Haley PM, McLaughlin CA, Pipe AL.
INTRODUCTION: Interventions for hospitalized smokers can increase long-term smoking cessation rates. The Ottawa Model for Smoking Cessation (the "Ottawa Model") is an application of the "5 A’s" approach to cessation, customized to the hospital setting. This study evaluated the impact of implementing the Ottawa Model in 9 hospitals in eastern Ontario.
METHODS: The RE-AIM (Reach, Efficacy, Adoption, Implementation, and Maintenance) framework was used to evaluate the intervention. Trained outreach facilitators assisted 9 hospitals to implement the Ottawa Model; program delivery was then monitored over a 1-year period using administrative data and data from a follow-up database. A before-and-after study was conducted to gauge the effect of the Ottawa Model program on cessation rates 6 months after hospitalization. Self-reports of smoking cessation were biochemically confirmed in a random sample of patients, and all cessation rates were corrected for potential misreporting.
RESULTS: Sixty-nine percent of the expected number of smokers received the Ottawa Model intervention. Controlling for hospital, the confirmed 6-month continuous abstinence rate was higher after, than before, introduction of the Ottawa Model (29.4% vs. 18.3%; odds ratio = 1.71, 95% CI = 1.11-2.64; Z = 2.43; I(2) = 0%; p = .02). The intervention was more likely to accomplish counseling for smokers than delivery of medications or postdischarge follow-up. Attitudinal, managerial, and environmental challenges to program implementation were identified.
DISCUSSION: Trained outreach facilitators successfully implemented the Ottawa Model in 9 hospitals leading to significantly higher long-term cessation rates. The public health implications of systematic cessation programs for hospitalized smokers are profound.
Reid RD, Mullen KA, Slovinec D’Angelo ME, et al. Nicotine Tob Res. 2009 Nov 10. [Epub ahead of print]
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戒烟的心理教育干预是否对冠心病患者有效？干预的荟萃分析
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全科医疗咨询过程中培养和维持患者的信任：戒烟建议案例
