scholarly journals Effect of Nicotine Replacement Therapy on Mortality, Delirium, and Duration of Therapy in Critically Ill Smokers: A Systematic Review and Meta-Analysis

2017 ◽  
Vol 45 (5) ◽  
pp. 556-561 ◽  
Author(s):  
K. T. Ng ◽  
M. Gillies ◽  
D. M. Griffith
Keyword(s):  
Systematic Review ◽  
Replacement Therapy ◽  
Nicotine Replacement Therapy ◽  
Critically Ill ◽  
Systematic Reviews ◽  
Odds Ratio ◽  
Observational Studies ◽  
Meta Analysis ◽  
Icu Mortality ◽  
Nicotine Replacement

Nicotine replacement therapy is widely used in critically ill smokers and its effect on delirium, mortality and duration of intensive care unit (ICU) admission is unknown. The aims of this review were to determine whether the management of nicotine withdrawal with nicotine replacement therapy reduces delirium, mortality or length of stay in critically ill smokers in ICU. The primary outcome was incidence of author-defined ICU delirium. Secondary outcomes were ICU or hospital mortality, ICU-free days at day 28, and ICU or hospital length of stay. We conducted a systematic review and meta-analysis of the data sources MEDLINE, EMBASE, CINAHL, and the Cochrane Database of Systematic Reviews for randomised controlled trials and observational studies. Clinical trials, observational studies and systematic reviews comparing nicotine replacement therapy with placebo or no treatment were included. Case reports, case series, non-systematic reviews and studies that involved children were excluded. Eight studies were eligible (n=2,636) for inclusion in the data synthesis. In a meta-analysis of observational studies, nicotine replacement therapy was associated with increased delirium (three studies; n=908; I2=0%; finite element method: odds ratio 4.03 [95% confidence interval 2.64, 6.15]; P <0.001). There was no difference in ICU mortality (three studies; n=1,309; P=0.10, I2=44%; finite element method: odds ratio 0.58; 95% confidence intervals 0.31– 1.10) and hospital mortality or 28-day ICU-free days. In the absence of high-quality data, nicotine replacement therapy cannot currently be recommended for routine use to prevent delirium or to reduce hospital or ICU mortality in critically ill smokers.

scholarly journals Evaluating level of adherence to nicotine replacement therapy and its impact on smoking cessation: a protocol for systematic review and meta-analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e039775 ◽  
Author(s):  
Amanual Getnet Mersha ◽  
Parivash Eftekhari ◽  
Michelle Bovill ◽  
Daniel Nigusse Tollosa ◽  
Gillian Sandra Gould
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Smoking Cessation ◽  
Replacement Therapy ◽  
Nicotine Replacement Therapy ◽  
Assessment Tool ◽  
Meta Analysis ◽  
Population Based ◽  
Reverse Causality ◽  
Nicotine Replacement

IntroductionNicotine replacement therapy (NRT) has proven effective for smoking cessation in clinical trials, however it was found less effective in population-based studies, potentially due to inconsistent or incorrect use of NRT. The aim of this paper is to describe a systematic review protocol to evaluate level of adherence to NRT; the discrepancy of adherence to NRT in clinical and population-based studies and degree of association between level of adherence and success of smoking cessation.Methods and analysisLiterature search will use five databases (Medline, Scopus, Embase, CINAHL and PsycINFO). Studies will be appraised for methodological quality using National Institutes of Health Quality Assessment Tool. To reduce heterogeneity, we will analyse clinical trials and population-based studies separately; pooled analyses will be done among studies that used similar measurements. Heterogeneity of studies will be assessed by Higgins’ I2 statistical test. When studies are adequately homogeneous, results will be pooled using random-effects model with proportion and ORs with 95% CIs and p values for each outcome. We will explain sources of heterogeneity by subgroup analysis or sensitivity analysis. Funnel plots and Egger’s regression asymmetry test with p<0.05 will be used as a cut-off point to affirm presence of statistically significant publication bias. Statistical analyses will be carried out using Stata V.16 software. Only studies reporting a valid strategy to control for reverse causality will be included.DiscussionThis review will provide evidence to support the importance of adherence on rate of smoking cessation and level of adherence to NRT. The findings will be used to inform smoking cessation interventions, researchers and policymakers.Ethics and disseminationAs a systematic literature review, this protocol does not require ethics approval. Research outcomes will be presented at relevant conferences and findings will be published in a relevant peer-reviewed journal.PROSPERO registration numberCRD42020176749.

scholarly journals Effectiveness and safety of nicotine replacement therapy assisted reduction to stop smoking: systematic review and meta-analysis

BMJ ◽  
2009 ◽  
Vol 338 (apr02 3) ◽  
pp. b1024-b1024 ◽  
Author(s):  
D. Moore ◽  
P. Aveyard ◽  
M. Connock ◽  
D. Wang ◽  
A. Fry-Smith ◽  
...  
Keyword(s):  
Systematic Review ◽  
Replacement Therapy ◽  
Nicotine Replacement Therapy ◽  
Meta Analysis ◽  
Nicotine Replacement ◽  
Stop Smoking

scholarly journals Fetal safety of nicotine replacement therapy in pregnancy: systematic review and meta‐analysis

Addiction ◽  
2020 ◽  
Author(s):  
Lauren Taylor ◽  
Ravinder Claire ◽  
Katarzyna Campbell ◽  
Tom Coleman‐Haynes ◽  
Jo Leonardi‐Bee ◽  
...  
Keyword(s):  
Systematic Review ◽  
Replacement Therapy ◽  
Nicotine Replacement Therapy ◽  
Meta Analysis ◽  
Nicotine Replacement ◽  
Fetal Safety ◽  
In Pregnancy

scholarly journals Comparison of nicotine exposure during pregnancy when smoking and abstinent with nicotine replacement therapy: systematic review and meta‐analysis

Addiction ◽  
2018 ◽  
Vol 114 (3) ◽  
pp. 406-424 ◽  
Author(s):  
Charlotte Hickson ◽  
Sarah Lewis ◽  
Katarzyna Anna Campbell ◽  
Sue Cooper ◽  
Ivan Berlin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Replacement Therapy ◽  
Nicotine Replacement Therapy ◽  
Meta Analysis ◽  
Nicotine Exposure ◽  
Nicotine Replacement ◽  
Exposure During Pregnancy

scholarly journals Evaluating level of adherence to nicotine replacement therapy and its impact on smoking cessation: a systematic review and meta-analysis

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Amanual Getnet Mersha ◽  
Parivash Eftekhari ◽  
Michelle Bovill ◽  
Daniel Nigusse Tollosa ◽  
Gillian Sandra Gould
Keyword(s):  
Systematic Review ◽  
Smoking Cessation ◽  
Pregnant Women ◽  
Replacement Therapy ◽  
Nicotine Replacement Therapy ◽  
Meta Analysis ◽  
Grey Literature ◽  
Population Based ◽  
P Value ◽  
Nicotine Replacement

Abstract Background Nicotine replacement therapy (NRT) has proven effect in assisting smoking cessation. However, its effectiveness varies across studies and population groups. This may be due to differences in the rate of adherence. Hence, this review aims to examine the level of adherence to NRT and to assess if the level of adherence to NRT affects success of smoking cessation. Methods A systematic review and meta-analysis was conducted using studies retrieved from five electronic databases (MEDLINE, Scopus, EMBASE, Web of science, and PsycINFO) and grey literature. Pooled analysis was conducted using Stata version 16 software. Methodological quality and risk of bias were assessed using the NIH Quality Assessment Tool. Analyses were done among those studies that used similar measurements to assess level of adherence and successful smoking cessation. Heterogeneity of studies was assessed using the Higgins’ I2 statistical test. Funnel plots and Egger’s regression asymmetry test were used to affirm presence of significant publication bias. Results A total of 7521 adult participants of 18 years old and above from 16 studies were included in the analysis. Level of adherence to NRT among participants of randomised controlled trials were found to be 61% (95% CI, 54–68%), p-value of < 0.001 and I2 = 85.5%. Whereas 26% of participants were adherent among participants of population-based studies with 95% CI, 20–32%, p-value of < 0.001 and I2 = 94.5%. Level of adherence was the lowest among pregnant women (22%) with 95% CI, 18–25%, p-value of 0.31 and I2 = 15.8%. Being adherent to NRT doubles the rate of successful quitting (OR = 2.17, 95% CI, 1.34–3.51), p-value of < 0.001 and I2 = 77.6%. Conclusions This review highlights a low level of adherence to NRT among participants of population-based studies and pregnant women as compared to clinical trials. Moreover, the review illustrated a strong association between adherence and successful smoking cessation. Hence, it is recommended to implement and assess large scale interventions to improve adherence. Health programs and policies are recommended to integrate the issue of adherence to NRT as a core component of smoking cessation interventions. Trial registration PROSPERO registration number: CRD42020176749. Registered on 28 April 2020.

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