Düzce Üniversitesi Tıp fakültesi Sağlık Uygulama ve Araştırma merkezi sigara bırakma polikliniği tedavi etkinliğinin değerlendirilmesi /
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Tarih
2021
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Düzce Üniversitesi
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info:eu-repo/semantics/openAccess
Özet
Amaç: Tütün bağımlılığı ve sigara içiciliği dünya çapında önlenebilir ölümlerin önde gelen nedenidir; kendisine kolay ulaşılabilir olması ve yasal olması nedeniyle kullanımı toplum içinde çok yaygın olan ve tedavi edilmesi gereken bir hastalıktır. Sigara ile mücadelede önemli bir yeri olan sigara bırakma polikliniklerinin tedavide başarı oranlarını ciddi şekilde arttırdığı gösterilmiştir. Bu çalışmanın amacı, sigarayı bırakmak için Düzce Üniversitesi Aile Hekimliği Anabilim Dalı bünyesindeki Sigara Bırakma Polikliniğine başvuran hastaların demografik ve sosyokültürel özelliklerini incelemek, sigara içme durumunu etkileyen faktörleri, uygulanan sigara bıraktırma tedavilerinin etkinliğini değerlendirmekti. Gereç-Yöntem: Çalışma Ocak 2018 - Aralık 2019 tarihleri arasında Düzce Üniversitesi Aile Hekimliği Anabilim dalı Sigara Bırakma polikliniğinde gerçekleştirildi. Çalışma prospektif, tanımlayıcı ve kesitsel çalışma olarak planlandı. Çalışmaya sigara bırakma polikliniğine başvuran ve tedaviye başlanıp önerilen kontrollere devam eden hastalar dâhil edildi. Hastaların nikotin bağımlılık seviyesinin belirlenmesi amacıyla Fagerstrom nikotin bağımlılık testi uygulandı ve bireylerin demografik özellikleri, sigara içme alışkanlıkları ve uygulanan tedaviler kayıt edildi. Çalışmada 'tekrar başlasa bile en az ?6ay bırakmayı başaran hastalar sigarayı bırakmış (başarılı)' olarak kabul edildi ve başarılı olanlar ve olmayanlar olarak ayrılan 2 grubun tüm özellikleri karşılaştırıldı. Bulgular: Çalışmaya alınan 427 (başarılı 202, başarısız 225 kişi) hastanın yaş ortalaması sırasıyla başarılı grupta 43,78±12,77, başarısız grupta 41,67±12,91 idi. Gruplar arasında yaş, cinsiyet, medeni durumu, çocuk varlığı, alkol tüketimi ve sigaraya başlama yaşı bakımından farklılık yoktu. Çalışmada Fagerstrom Nikotin Bağımlılık Testinin (FNBT) başarısız grupta anlamlı olarak daha yüksek olduğu belirlendi (başarılı 5 (3), başarısız 6 (2), p<0,001). Hastaların tedavi oranları açısından başarılı grupta Vareniklin + Nikotin replasman tedavisi + Bilişsel davranışçı terapi alanların başarı oranı daha yüksekti (başarılı %5, başarısız 0,5, p=0,046). Ayrıca daha önce sigara bırakmayı denemenin varlığı başarılı grupta anlamlı olarak yüksekti (başarılı %90,6, başarısız %81,8, p=0,009). Sonuç: Çalışmada tedavinin başarıya ulaşmasında; FNBT skorunun, günlük tüketilen sigara adedinin, daha önce sigara bırakmayı denemiş olmanın, yan etki nedeniyle tedavinin yarıda bırakılmasının ve tedavi seçeneğinin etkili olduğu belirlendi. Sigara bırakma tedavisi sırasında hastanın; bağımlılık düzeyi, daha önceki sigara bırakma deneyimleri ve tedavi yan etkileri ile beraber değerlendirilerek desteklenmesi gerektiğini düşünmekteyiz. Sigara bağımlılığı, önlenebilir olması nedeniyle sigara bırakma tedavisi sırasında her aşamada hastaya verilen destek toplum sağlığını da geliştirecektir.
Purpose: Tobacco addiction and smoking are the leading causes of preventable deaths worldwide; It is a disease that is very common in the society and needs to be treated because it is easily accessible and legal. It has been shown that smoking cessation outpatient clinics, which have an important place in the fight against smoking, significantly increase the success rates in treatment. The aim of this study was to examine the demographic and sociocultural characteristics of the patients who applied to the Smoking Cessation Outpatient Clinic of Düzce University Family Medicine Department to quit smoking, to evaluate the factors affecting smoking status and the effectiveness of smoking cessation treatments. Materials and Methods: The study was carried out between January 2018 and December 2019 in Düzce University, Department of Family Medicine, Smoking Cessation Clinic. The study was planned as a prospective, descriptive and cross-sectional study. Patients who applied to the smoking cessation clinic and started treatment and continued the recommended controls were included in the study. In order to determine the nicotine addiction level of the patients, the Fagerstrom nicotine addiction test was applied and the demographic characteristics of the individuals, smoking habits and the treatments applied were recorded. In the study, "the patients who managed to quit smoking for at least 6 months even if they started again" were considered to have quit smoking (successful) and all the characteristics of the 2 groups separated as successful and non-successful were compared. Conclusion: The mean age of 427 patients (202 successful, 225 unsuccessful) included in the study was 43.78 ± 12.77 in the successful group and 41.67 ± 12.91 in the unsuccessful group, respectively. There was no difference between the groups in terms of age, gender, marital status, presence of children, alcohol consumption and starting age of smoking. In the study, Fagerstrom Nicotine Dependency Test (FNBT) was found to be significantly higher in the unsuccessful group (successful 5 (3), unsuccessful 6 (2), p <0.001). The success rate of patients who received Varenicline + Nicotine replacement therapy + Cognitive behavioral therapy was higher in the successful group in terms of treatment rates (successful 5%, unsuccessful 0.5, p = 0.046). In addition, the presence of previous smoking cessation was significantly higher in the successful group (successful 90.6%, unsuccessful 81.8%, p = 0.009). Results: In the success of the treatment in the study; It was determined that the FNBT score, the number of cigarettes consumed per day, having tried to quit smoking before, stopping the treatment due to side effects and the treatment option were effective. During smoking cessation treatment, the level of addiction should be evaluated together with previous smoking cessation experiences, treatment side effects and the patient should be supported based on these factors. Since smoking addiction is preventable, the support given to the patient at every stage during smoking cessation treatment will also improve the public health.
Purpose: Tobacco addiction and smoking are the leading causes of preventable deaths worldwide; It is a disease that is very common in the society and needs to be treated because it is easily accessible and legal. It has been shown that smoking cessation outpatient clinics, which have an important place in the fight against smoking, significantly increase the success rates in treatment. The aim of this study was to examine the demographic and sociocultural characteristics of the patients who applied to the Smoking Cessation Outpatient Clinic of Düzce University Family Medicine Department to quit smoking, to evaluate the factors affecting smoking status and the effectiveness of smoking cessation treatments. Materials and Methods: The study was carried out between January 2018 and December 2019 in Düzce University, Department of Family Medicine, Smoking Cessation Clinic. The study was planned as a prospective, descriptive and cross-sectional study. Patients who applied to the smoking cessation clinic and started treatment and continued the recommended controls were included in the study. In order to determine the nicotine addiction level of the patients, the Fagerstrom nicotine addiction test was applied and the demographic characteristics of the individuals, smoking habits and the treatments applied were recorded. In the study, "the patients who managed to quit smoking for at least 6 months even if they started again" were considered to have quit smoking (successful) and all the characteristics of the 2 groups separated as successful and non-successful were compared. Conclusion: The mean age of 427 patients (202 successful, 225 unsuccessful) included in the study was 43.78 ± 12.77 in the successful group and 41.67 ± 12.91 in the unsuccessful group, respectively. There was no difference between the groups in terms of age, gender, marital status, presence of children, alcohol consumption and starting age of smoking. In the study, Fagerstrom Nicotine Dependency Test (FNBT) was found to be significantly higher in the unsuccessful group (successful 5 (3), unsuccessful 6 (2), p <0.001). The success rate of patients who received Varenicline + Nicotine replacement therapy + Cognitive behavioral therapy was higher in the successful group in terms of treatment rates (successful 5%, unsuccessful 0.5, p = 0.046). In addition, the presence of previous smoking cessation was significantly higher in the successful group (successful 90.6%, unsuccessful 81.8%, p = 0.009). Results: In the success of the treatment in the study; It was determined that the FNBT score, the number of cigarettes consumed per day, having tried to quit smoking before, stopping the treatment due to side effects and the treatment option were effective. During smoking cessation treatment, the level of addiction should be evaluated together with previous smoking cessation experiences, treatment side effects and the patient should be supported based on these factors. Since smoking addiction is preventable, the support given to the patient at every stage during smoking cessation treatment will also improve the public health.
Açıklama
Anahtar Kelimeler
Aile Hekimliği, Family Medicine, Tütün, Sigara bırakma polikliniği, Vareniklin, Nikotin replasman tedavisi, Bilişsel davranış terapisi, Tobacco, Smoking cessation clinic, Varenicline, Nicotine replacement therapy, Cognitive behavioral therapy
