Prescribing Prevalence, Effectiveness, and Mental Health Safety of Smoking Cessation Medicines in Patients With Mental Disorders

被引：45

作者：

Taylor, Gemma M. J. ^{[1
,2
,3
]}

Itani, Taha ^{[1
,2
]}

Thomas, Kyla H. ^{[4
]}

Rai, Dheeraj ^{[4
,5
]}

Jones, Tim ^{[6
]}

Windmeijer, Frank ^{[1
,7
]}

Martin, Richard M. ^{[1
,4
,8
,9
]}

Munafo, Marcus R. ^{[1
,2
]}

Davies, Neil M. ^{[1
,4
]}

Taylor, Amy E. ^{[4
,8
,9
]}

机构：

[1] Univ Bristol, Bristol Med Sch, Med Res Council, Integrat Epidemiol Unit,Populat Hlth Sci, Bristol, Avon, England

[2] Univ Bristol, Sch Psychol Sci, UK Ctr Tobacco & Alcohol Studies, Bristol, Avon, England

[3] Univ Bath, Dept Psychol, Addict & Mental Hlth Grp AIM, 10 West,Room 3-47, Bath BA2 7AY, Avon, England

[4] Univ Bristol, Bristol Med Sch, Populat Hlth Sci, Canynge Hall, Bristol, Avon, England

[5] Univ Bristol, Ctr Acad Mental Hlth, Bristol, Avon, England

[6] Univ Hosp Bristol NHS Fdn Trust, Natl Inst Hlth Res Collaborat Leadership Appl Hlt, Bristol, Avon, England

[7] Univ Bristol, Dept Econ, Bristol, Avon, England

[8] Univ Hosp Bristol NHS Fdn Trust, NIHR Biomed Res Ctr, Bristol, Avon, England

[9] Univ Bristol, Bristol, Avon, England

来源：

NICOTINE & TOBACCO RESEARCH | 2020年 / 22卷 / 01期

基金：

美国国家卫生研究院; 英国医学研究理事会;

关键词：

NICOTINE REPLACEMENT THERAPY; PRIMARY-CARE; PRESCRIPTIONS; VARENICLINE; VALIDATION; DATABASE;

D O I：

10.1093/ntr/ntz072

中图分类号：

R194 [卫生标准、卫生检查、医药管理];

学科分类号：

摘要：

Objective: We conducted a prospective cohort study of the Clinical Practice Research Database to estimate rates of varenicline and nicotine replacement therapy (NRT) prescribing and the relative effects on smoking cessation, and mental health. Methods: We used multivariable logistic regression, propensity score matched regression, and instrumental variable analysis. Exposure was varenicline or NRT prescription. Mental disorders were bipolar, depression, neurotic disorder, schizophrenia, or prescriptions of antidepressants, antipsychotics, hypnotics/anxiolytics, mood stabilizers. Outcomes were smoking cessation, and incidence of neurotic disorder, depression, prescription of antidepressants, or hypnotics/anxiolytics. Follow-ups were 3, 6, and 9 months, and at 1, 2, and 4 years. Results: In all patients, NRT and varenicline prescribing declined during the study period. Seventy-eight thousand four hundred fifty-seven smokers with mental disorders aged >= 18 years were prescribed NRT (N = 59 340) or varenicline (N = 19 117) from September 1, 2006 to December 31, 2015. Compared with smokers without mental disorders, smokers with mental disorders had 31% (95% CI: 29% to 33%) lower odds of being prescribed varenicline relative to NRT, but had 19% (95% CI: 15% to 24%) greater odds of quitting at 2 years when prescribed varenicline relative to NRT. Overall, varenicline was associated with decreased or similar odds of worse mental health outcomes than NRT in patients both with and without mental disorders, although there was some variation when analyses were stratified by mental disorder subgroup. Conclusions: Smoking cessation medication prescribing may be declining in primary care. Varenicline was more effective than NRT for smoking cessation in patients with mental disorders and there is not clear consistent evidence that varenicline is adversely associated with poorer mental health outcomes.

引用

页码：48 / 57

页数：10

共 37 条

[1]

[Anonymous], Adult smoking habits in the UK: 2016

[2]

[Anonymous], 2019, WHO REPORT GLOBAL TO

[3] Neuropsychiatric safety and efficacy of varenicline, bupropion, and nicotine patch in smokers with and without psychiatric disorders (EAGLES): a double-blind, randomised, placebo-controlled clinical trial [J].