Effectiveness of multicomponent interventions in primary healthcare settings to promote continuous smoking cessation in adults: a systematic review

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 crite...

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Main Authors: Carlos Martín Cantera, Elisa Puigdomènech, Jose Luis Ballvé, Olga Lucía Arias, Lourdes Clemente, Ramon Casas, Lydia Roig, Santiago Pérez-Tortosa, Laura Díaz-Gete, Sílvia Granollers
Format: Article
Language:English
Published: BMJ Publishing Group 2015-10-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/5/10/e008807.full
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author Carlos Martín Cantera
Elisa Puigdomènech
Jose Luis Ballvé
Olga Lucía Arias
Lourdes Clemente
Ramon Casas
Lydia Roig
Santiago Pérez-Tortosa
Laura Díaz-Gete
Sílvia Granollers
author_facet Carlos Martín Cantera
Elisa Puigdomènech
Jose Luis Ballvé
Olga Lucía Arias
Lourdes Clemente
Ramon Casas
Lydia Roig
Santiago Pérez-Tortosa
Laura Díaz-Gete
Sílvia Granollers
author_sort Carlos Martín Cantera
collection DOAJ
description 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.
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spelling doaj-art-91aaec9581fc4b82961f6efdf191e8f62025-02-02T01:20:12ZengBMJ Publishing GroupBMJ Open2044-60552015-10-0151010.1136/bmjopen-2015-008807Effectiveness of multicomponent interventions in primary healthcare settings to promote continuous smoking cessation in adults: a systematic reviewCarlos Martín Cantera0Elisa Puigdomènech1Jose Luis Ballvé2Olga Lucía Arias3Lourdes Clemente4Ramon Casas5Lydia Roig6Santiago Pérez-Tortosa7Laura Díaz-Gete8Sílvia Granollers91Unitat de Suport a la Recerca Barcelona, Institut Universitari d`Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain1Unitat de Suport a la Recerca Barcelona, Institut Universitari d`Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain4Centre d`Atenció Primària (CAP) Florida Nord, Institut Català de la Salut (ICS), Hospitalet de Llobregat, Barcelona, Spain4Centre d`Atenció Primària (CAP) Florida Nord, Institut Català de la Salut (ICS), Hospitalet de Llobregat, Barcelona, Spain5Centro de Salud Santo Grial, Huesca, Spain6Centre d`Atenció Primària (CAP) Sant Antoni, Institut Català de la Salut (ICS), Barcelona, Spain7Centre d`Atenció Primària (CAP) La Garriga, Institut Català de la Salut (ICS), La Garriga, Barcelona, Spain9Centre d`Atenció Primària (CAP) La Llagosta, Institut Català de la Salut (ICS), La Llagosta, Spain10Centre d`Atenció Primària (CAP) la Sagrera, Institut Català de la Salut (ICS), Barcelona, Spain11Centre d`Atenció Primària (CAP) Esplugues de Llobregat, Institut Català de la Salut (ICS), Esplugues de Llobregat, SpainObjective 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.https://bmjopen.bmj.com/content/5/10/e008807.full
spellingShingle Carlos Martín Cantera
Elisa Puigdomènech
Jose Luis Ballvé
Olga Lucía Arias
Lourdes Clemente
Ramon Casas
Lydia Roig
Santiago Pérez-Tortosa
Laura Díaz-Gete
Sílvia Granollers
Effectiveness of multicomponent interventions in primary healthcare settings to promote continuous smoking cessation in adults: a systematic review
BMJ Open
title Effectiveness of multicomponent interventions in primary healthcare settings to promote continuous smoking cessation in adults: a systematic review
title_full Effectiveness of multicomponent interventions in primary healthcare settings to promote continuous smoking cessation in adults: a systematic review
title_fullStr Effectiveness of multicomponent interventions in primary healthcare settings to promote continuous smoking cessation in adults: a systematic review
title_full_unstemmed Effectiveness of multicomponent interventions in primary healthcare settings to promote continuous smoking cessation in adults: a systematic review
title_short Effectiveness of multicomponent interventions in primary healthcare settings to promote continuous smoking cessation in adults: a systematic review
title_sort effectiveness of multicomponent interventions in primary healthcare settings to promote continuous smoking cessation in adults a systematic review
url https://bmjopen.bmj.com/content/5/10/e008807.full
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