Increasing Adherence to Tobacco Cessation Intervention

提高戒烟干预的依从性

• 批准号: 8381519
• 负责人: MICHAEL C FIORE
• 金额: $ 21.84万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/8381519
• 关键词: Abstinence; Address; Adherence; Affect; Behavior; Belief; Cognitive; Counseling; Coupled; Dose; Engineering; FDA approved; Failure; Feedback; Frequencies; Goals; Health; Healthcare; Instruction; Intervention; Knowledge; Laboratories; Measures; Mediating; Nicotine Dependence; Outcome; Pharmaceutical Preparations; Problem Solving; Public Health; Randomized Clinical Trials; Recruitment Activity; Relative (related person); Research; Role; Route; Series; Severities; Smoker; Testing; Time; Tobacco Dependence; Tobacco Use Cessation; Tobacco use; Translating; Withdrawal; Withdrawal Symptom; Withholding Treatment; base; contingency management; cost effective; design; effective intervention; improved; indexing; intervention effect; medication compliance; primary care setting; research study; smoking cessation; success; therapy design

Nonadherent use of smoking cessation medications is very common and highly associated with failure to quit smoking. However, little is presently known about how to affect adherence, or whether greater adherence will actually improve cessation success (i.e., its causal role is unknown). Project 3 is designed to address three chief aims: (1) to identify the factors that influence adherence to smoking cessation medication; (2) to determine the association between medication adherence and smoking cessation, and (3) to develop new, cost-effective adherence interventions that are feasible for use in real-world healthcare settings and that improve both medication adherence and smoking cessation outcomes. These research goals will be addressed via two experiments conducted in real-world primary care settings that will assess several types of promising adherence interventions designed to boost both adherence rates and cessation success. These interventions include a cognitive intervention designed to modify smokers' incorrect beliefs about medication and cessation, interventions that provide feedback and problem solving counseling based upon real-time recording of medication use, and a contingency management intervention that reinforces adherence behavior. Strengths of this research are that it will: use smokers recruited in primary care settings; reveal the relative, additive, and interactive effects of these adherence interventions; use multiple, convergent measures to achieve an accurate assessment of adherence; and use mediational analyses to reveal the extent to which adherence change translates into higher abstinence rates. Finally, this research will identify an optimal set of adherence interventions for use in real-world settings. Such interventions might be used for a broad range of health conditions where medication adherence is a problem.

不坚持使用戒烟药物非常常见，并且与戒烟失败密切相关。然而，目前人们对如何影响依从性，或者更大的依从性是否会真正提高戒烟成功率知之甚少（即，其因果作用尚不清楚）。项目 3 旨在实现三个主要目标：(1) 确定影响戒烟药物依从性的因素； (2) 确定药物依从性和戒烟之间的关联，(3) 开发新的、具有成本效益的依从性干预措施，这些干预措施可用于现实世界的医疗保健环境，并改善药物依从性和戒烟结果。这些研究目标将通过在现实世界初级保健环境中进行的两项实验来实现，这些实验将评估几种有希望的依从性干预措施，旨在提高依从率和戒烟成功率。这些干预措施包括旨在改变吸烟者对药物和戒烟的错误信念的认知干预措施、基于药物使用实时记录提供反馈和问题解决咨询的干预措施，以及加强依从行为的应急管理干预措施。这项研究的优势在于： 使用在初级保健机构中招募的吸烟者；揭示这些依从性干预措施的相对、相加和交互作用；使用多种聚合措施来实现准确的依从性评估；并使用中介分析来揭示依从性变化在多大程度上转化为更高的戒断率。最后，这项研究将确定一套最佳的依从性干预措施，以供在现实环境中使用。此类干预措施可用于治疗依从性存在问题的各种健康状况。