RESUMO
BACKGROUND/OBJECTIVE: Tobacco use remains the leading cause of preventable death in the United States. The most widely available treatment options to assist patients in smoking cessation are limited by side effects and moderate efficacy at best. Acupuncture may be an effective option for smoking cessation. The goal of this study was to establish the need for and interest in acupuncture therapy to potentially assist with smoking cessation from a patient perspective. METHODS: We conducted a cross-sectional survey study among patients aged 18 years or older whose medical record reported current tobacco use with English as their preferred language. REDCap surveys were administered to patients during office visits and included questions regarding opinions and use of all treatments available for smoking cessation (including acupuncture) as well as perceived barriers to acupuncture treatment. RESULTS: A total of 57 surveys were distributed, and 42 (74%) were completed. Most patients reported previous attempts at quitting (76%) and had tried a variety of treatments including nicotine replacement (45%), Chantix (varenicline; 23%), Wellbutrin (bupriopion; 19%), "cold turkey" (65%) and hypnosis (3%). No respondents reported having tried acupuncture for smoking cessation. CONCLUSION: When comparing treatment options, patients reported more interest in acupuncture than other treatment options with a statistically significant difference in the level of interest between acupuncture and bupropion. All barriers (cost, time and effectiveness) were equally rated on a Likert-type scale with a median of 50 on a 101-point scale.
Assuntos
Terapia por Acupuntura , Alcaloides , Abandono do Hábito de Fumar , Humanos , Nicotina/efeitos adversos , Agonistas Nicotínicos/efeitos adversos , Alcaloides/uso terapêutico , Estudos Transversais , Benzazepinas/efeitos adversos , Quinoxalinas/efeitos adversos , Dispositivos para o Abandono do Uso de Tabaco , Vareniclina , Bupropiona/uso terapêuticoRESUMO
BACKGROUND: Rates of individuals with a psychotherapy visit has not been well studied, and recent reports lack granularity by age. METHODS: The 2017-2019 Medical Expenditure Panel Survey (MEPS) was used to investigate rates and associations of psychotherapy and psychiatry visits by age/sex and antidepressant/antipsychotic use. RESULTS: The study included all 90,853 individuals, of which 5.2% (95% CI, 4.9-5.4) reported any psychotherapy (excluding psychiatry visits) visit during a year, while 3.6% (95% CI, 3.4-3.8) reported a visit with a psychiatrist. Females were more likely to have a psychotherapy visit than males after 15 years of age. The highest rates of females with a psychotherapy visit were between 15 and 30 years of age, while rates among males were highest between 10 to 25 years of age. For psychiatry visits, males had higher rates than females during preteen years, similar rates through teen years, lower rates though adulthood, and similar rates after 60 years of age. Rates of a psychiatry visit did not vary as much by age as a psychotherapy visit. Among antidepressant or antipsychotic medication users, the rate of either a psychotherapy visit or a psychiatry visit during a year was markedly higher at younger ages and decreased as age advanced. CONCLUSION: Psychotherapy and psychiatry utilization have differences in population level patterns with use being highest among females between 15 to 30 years of age and higher among younger (compared with older) individuals who reported antidepressants or antipsychotics.
RESUMO
There is a documented substantial gap between the level of nutrition education for medical trainees and the need to provide nutrition counseling. Culinary medicine offers a solution, but there are multiple barriers and no guides to implementation. This article identifies core components and strategies to overcome barriers on the basis of experiences of multiple institutions. The outline forms a foundation to be built upon by future collaborators to empower more widespread implementation of culinary medicine education and improve medical nutrition education and ultimately, patient outcomes.