ABSTRACT
This study aims to evaluate the effect of regularly reporting spirometry results during smoking cessation counseling from a primary care physician on the quit rate in adult smokers. METHODS: A randomized, two-arm intervention study was conducted at six primary care centers. A total of 350 smokers, ≥18 years of age, who consulted their primary care physician, participated in the study. At the selection visit, smokers who gave their consent to participate underwent spirometry. Subsequently, an appointment (visit 0) was scheduled to complete a nicotine dependence test, a smoking cessation motivation questionnaire, and a sociodemographic questionnaire. Participants were also offered brief, structured advice on how to quit smoking, as well as detailed information on spirometry results. Patients were then randomized and scheduled for follow-up visits at 3, 6, 12, and 24 months. Both arms received brief, structured advice and detailed information on spirometry results at visit 0. At consecutive follow-up visits, the control group only received brief, structured smoking cessation advice, while the intervention group also received information on initial spirometry results at visits 3 and 6, and a spirometry retest at visit 12. Exhaled carbon monoxide testing was used to check smoking cessation. RESULTS: The study included 350 smokers; 179 were assigned to the control group and 171 to the intervention group. Smoking cessation at one year was 24.0% in the intervention group compared to 16.2% in the control group. At two years, it was 25.2% in the intervention group and 18.4% in the control group. Overall, the adjusted odds of quitting smoking in the intervention group were 42% higher than in the control group (p = 0.018). CONCLUSIONS: Regular and detailed feedback of spirometry results with smokers increases smoking cessation. Specifically, the likelihood of quitting smoking in the intervention group is 1.42 times higher than in the control group (p = 0.018).
Subject(s)
Smoking Cessation , Adult , Humans , Smoking Cessation/methods , Smoking Prevention , Smoking/psychology , Spirometry , Primary Health Care/methodsABSTRACT
Objetivo: valorar el grado de resolución del profesional enfermero en laatención urgente de los equipos de Atención Primaria del Maresme (Barcelona)mediante la aplicación del triage en el año 2007.Material y método: diseño descriptivo retrospectivo realizado sobre las visitasgeneradas en 13 áreas básicas de salud del Servicio de Atención PrimariaMataró-Maresme. Los sujetos del estudio fueron los pacientes de cualquieredad que acudieron al centro con autopercepción de urgencia y fueron visitadosel mismo día por la enfermera, durante el período comprendido entreenero y diciembre de 2007. Las variables estudiadas fueron el sexo, la edad,resolución de la visita (resolución enfermera o derivación a su médico de familia/pediatra pasadas 24 horas o derivación al médico de familia/pediatra).Resultados: se analizaron un total de 53.962 visitas que fueron atendidascomo urgentes por parte de la enfermera. La media de edad de los pacientesfue de 39,9 años y un 54,1% eran mujeres. El 84,6% de los pacientes teníanmás de 14 años. El porcentaje de resolución fue del 42%, el cual disminuíasignificativamente (p < 0,000) a 31,4% si el paciente era menor de 15 años.Conclusiones: el elevado grado de resolución enfermero obtenido, evidenciaque la enfermera puede ser la puerta de entrada al sistema sanitario,dando respuesta a la demanda urgente, ya sea resolviendo o gestionándola (AU)
Objective: to assess the degree in which nursing staff of the primary careteams of the Maresme area (Barcelona) resolve urgent care demand by applyingtriage in 2007.Material and methods: retrospective descriptive design performed on visitsgenerated in 13 basic health areas of the Mataro-Maresme Primary Careservice. The study subjects were patients of any age who attended the centrewith self-perceived urgency and were seen the same day by the nurse, duringthe period ranging from January to December 2007. Studied variableswere sex, age, how the visit was resolved (by the nurse or by referral to thepatients family doctor/pediatrician).Results: a total of 53,962 visits that were managed as urgent by nurseswere analysed. The patient mean age was 39.9 years and 54.1% werewomen. 84.6% of patients were over the age of 14. 42% of cases were resolved,which decreased significantly (p < 0.000) to 31.4% if the patient wasunder the age of 15.Conclusions: the high degree in which nurses resolved urgent visits is evidencethat the nurse may be the first point of entry into the health care system,responding to urgent needs, whether it is by resolving the consultationor managing it (AU)