Treatment for Tobacco Dependence for Rural, Lower-Income Smokers: Outcomes, Predictors, and Measurement Considerations

2009 ◽  
Vol 23 (5) ◽  
pp. 328-338 ◽  
Author(s):  
Christine E. Sheffer ◽  
Maxine Stitzer ◽  
Thomas J. Payne ◽  
Bradford W. Applegate ◽  
David Bourne ◽  
...  
Keyword(s):  
Smoking Status ◽  
Behavioral Therapy ◽  
Tobacco Dependence ◽  
Evidence Based ◽  
Long Term Outcomes ◽  
Lower Socioeconomic Status ◽  
Intention To Treat ◽  
Lower Socioeconomic ◽  
Treat Analysis

Purpose. Outcomes from a statewide program that delivered evidence-based, intensive treatment for tobacco dependence to a rural population of lower socioeconomic status (SES) were evaluated. Factors that predicted success and measurement considerations were examined. Design and Analyses. Data were collected at intake, at all treatment sessions, and at 3- and 12-months posttreatment. Abstinence rates were calculated using complete-case analysis and intention-to-treat analysis, and they were estimated for all participants. Logistic regression was used to evaluate the predictive significance of demographic and clinical factors. Setting. Twenty health care sites across Arkansas. Participants. A total of 2,350 predominantly rural, lower SES, Arkansas residents. Intervention. Evidence-based, six-session, multi-component cognitive-behavioral therapy with relapse prevention. Results. The estimated percent abstinent was 26.47% at 3-months and 21.73% at 12-months posttreatment; 51.02%) of patients completed treatment and demonstrated markedly higher quit rates. Although numerous factors predicted outcomes at different points, self-efficacy and dependence levels at intake were robust predictors across time and methods of calculating outcomes. Sex, partner smoking status, and educational level were significant predictors of long-term abstinence. Conclusions. This study demonstrates that intensive, evidence-based treatment for tobacco dependence can be successfully delivered in a statewide program and can yield long-term outcomes that approximate those seen in more controlled settings. Overall sample estimates may be more appropriate for the assessment of outcomes in this context.

Evidence-Based Cognitive Rehabilitation for People With Multiple Sclerosis: A Systematic Review

2021 ◽  
Vol 75 (Supplement_2) ◽  
pp. 7512520385p1-7512520385p1
Author(s):  
Yu-Chih Chen ◽  
Szu-Wei Chen ◽  
Britney Ferri
Keyword(s):  
Processing Speed ◽  
Cognitive Skills ◽  
Cognitive Rehabilitation ◽  
Evidence Based ◽  
Long Term Outcomes ◽  
Noninvasive Brain Stimulation ◽  
Future Studies ◽  
Cognitive Improvement ◽  
Computer Based

Abstract Date Presented 04/22/21 Computer-based programs, conventional cognitive rehabilitation, neurologic music therapy, and noninvasive brain stimulation are effective in improving memory and learning, processing speed, language, executive function, or general cognitive skills. However, the retention of treatment effects and the generalizability of the cognitive improvement to the daily occupations are not clear. Including a predetermined single outcome, functional and long-term outcomes are needed in future studies. Primary Author and Speaker: Yu-Chih Chen Contributing Authors: Nicole Gerhardt, Christina Calhoun Thielen, Winnie Dunn, and Mary Jane Mulcahey

183 MELD CLASS AND LONG-TERM SURVIVAL BENEFIT OF LIVER TRANSPLANTATION: AN INTENTION-TO-TREAT ANALYSIS

2008 ◽  
Vol 48 ◽  
pp. S77-S78
Author(s):  
A.W. Avolio ◽  
M. Siciliano ◽  
S. Agnes ◽  
A. Gasbarrini ◽  
G. Caracciolo ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Survival Benefit ◽  
Term Survival ◽  
Long Term Survival ◽  
Intention To Treat ◽  
Treat Analysis

scholarly journals Analysis of overlapping surgery in patients undergoing microsurgical aneurysm clipping: acute and long-term outcomes from the Barrow Ruptured Aneurysm Trial

2018 ◽  
Vol 129 (3) ◽  
pp. 711-717 ◽  
Author(s):  
Michael A. Mooney ◽  
Scott Brigeman ◽  
Michael A. Bohl ◽  
Elias D. Simon ◽  
John P. Sheehy ◽  
...  
Keyword(s):  
Smoking Status ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Ruptured Aneurysm ◽  
Long Term Outcomes ◽  
Microsurgical Clipping ◽  
Fisher Grade ◽  
Medicine Today ◽  
Saccular Aneurysms

OBJECTIVEOverlapping surgery is a controversial subject in medicine today; however, few studies have examined the outcomes of this practice. The authors analyzed outcomes of patients with acutely ruptured saccular aneurysms who were treated with microsurgical clipping in a prospectively collected database from the Barrow Ruptured Aneurysm Trial. Acute and long-term outcomes for overlapping versus nonoverlapping cases were compared.METHODSDuring the study period, 241 patients with ruptured saccular aneurysms underwent microsurgical clipping. Patients were separated into overlapping (n = 123) and nonoverlapping (n = 118) groups based on surgical start/stop times. Outcomes at discharge and at 6 months, 1 year, 3 years, and 6 years after surgery were analyzed.RESULTSPatient variables (e.g., age, smoking status, cardiovascular history, Hunt and Hess grade, Fisher grade, and aneurysm size) were similar between the 2 groups. Aneurysm locations were similar, with the exception of the overlapping group having more posterior circulation aneurysms (18/123 [15%]) than the nonoverlapping group (8/118 [7%]) (p = 0.0495). Confirmed aneurysm obliteration at discharge was significantly higher for the overlapping group (109/119 [91.6%]) than for the nonoverlapping group (95/116 [81.9%]) (p = 0.03). Hospital length of stay, discharge location, and proportions of patients with a modified Rankin Scale (mRS) score > 2 at discharge and up to 6 years postoperatively were similar. The mean and median mRS, Glasgow Outcome Scale, Mini–Mental State Examination, National Institutes of Health Stroke Scale, and Barthel Index scores at all time points were not statistically different between the groups.CONCLUSIONSCompared with nonoverlapping surgery, overlapping surgery was not associated with worse outcomes for any variable at any time point, despite the complexity of the surgical management in this patient population. These findings should be considered during the discussion of future guidelines on the practice of overlapping surgery.

Smoking cessation guidelines: evidence-based recommendations of the French Health Products Safety Agency

2005 ◽  
Vol 20 (5-6) ◽  
pp. 431-441 ◽  
Author(s):  
B. Le Foll ◽  
P. Melihan-Cheinin ◽  
G. Rostoker ◽  
G. Lagrue ◽  
Keyword(s):  
Cognitive Therapy ◽  
Nicotine Dependence ◽  
Pharmacological Treatment ◽  
Smoking Status ◽  
Single Agent ◽  
Smoking Behavior ◽  
Developed Countries ◽  
Evidence Based ◽  
Health Products

AbstractTobacco use is the leading preventable cause of death in developed countries. Millions of smokers are willing to stop, but few of them are able to do so. Clinicians should only use approaches that have demonstrated their efficacy in helping patients to stop smoking. This article summarizes the evidence-based major findings and clinical recommendations for the treatment of tobacco dependence of the French Health Products Safety Agency (AFSSAPS). Clinicians should enquire about the smoking status of each patient and provide information about health consequence of smoking and effective treatments available. These treatments include counseling (mainly individual or social support and behavioral and cognitive therapy) and pharmacological treatment with either nicotine replacement therapy (NRT) or bupropion LP. Pharmacological treatments should be used only for proven nicotine dependence, as assessed by the Fagerstrom test for Nicotine Dependence. The choice of pharmacologic treatment depends of the patient's preference and history and of the presence of contra-indications. The clinician should start with a single agent, but these treatments may be used in combination. Smoking behavior is a chronic problem that requires long-term management and follow-up. Access to intensive treatment combining pharmacological treatment and extensive behavioral and cognitive therapy should be available for highly dependent patients.

scholarly journals Smoking status at diagnosis and histology type as determinants of long-term outcomes of lung cancer patients

2012 ◽  
Vol 43 (5) ◽  
pp. 919-924 ◽  
Author(s):  
Michael Poullis ◽  
James McShane ◽  
Mathew Shaw ◽  
Michael Shackcloth ◽  
Richard Page ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Smoking Status ◽  
Long Term Outcomes ◽  
Lung Cancer Patients

scholarly journals Anticarbamylated protein antibodies are associated with long-term disability and increased disease activity in patients with early inflammatory arthritis: results from the Norfolk Arthritis Register

2015 ◽  
Vol 75 (6) ◽  
pp. 1139-1144 ◽  
Author(s):  
Jennifer H Humphreys ◽  
Marije K Verheul ◽  
Anne Barton ◽  
Alexander J MacGregor ◽  
Mark Lunt ◽  
...  
Keyword(s):  
Disease Activity ◽  
Random Effects ◽  
Inflammatory Arthritis ◽  
Smoking Status ◽  
Health Assessment ◽  
Joint Disease ◽  
Random Effects Model ◽  
Long Term Outcomes ◽  
Acpa Status

ObjectivesAnticarbamylated protein (anti-CarP) antibodies are a novel family of autoantibodies recently identified in patients with inflammatory arthritis. The aim of this study was to investigate their association with long-term outcomes of disability and disease activity over 20 years’ follow-up in a cohort of patients with inflammatory polyarthritis (IP).MethodsNorfolk Arthritis Register recruited adults with recent-onset swelling of ≥2 joints for ≥4 weeks from 1990 to 2009. At baseline, Health Assessment Questionnaire (HAQ) and 28 joint disease activity scores (DAS28) were obtained, and C reactive protein, rheumatoid factor (RF), anticitrullinated protein antibodies (ACPA) and anti-CarP antibodies were measured. Further HAQ scores and DAS28 were obtained at regular intervals over 20 years. Generalised estimating equations were used to test the association between anti-CarP antibody status and longitudinal HAQ and DAS28 scores; adjusting for age, gender, smoking status, year of inclusion and ACPA status. Analyses were repeated in subgroups stratified by ACPA status. The relative association of RF, ACPA and anti-CarP antibodies with HAQ and DAS28 scores was investigated using a random effects model.Results1995 patients were included; 1310 (66%) were female. Anti-CarP antibodies were significantly associated with more disability and higher disease activity, HAQ multivariate β-coefficient (95% CI) 0.12 (0.02 to 0.21), and these associations remained significant in the ACPA-negative subgroups. The associations of RF, ACPA and anti-CarP antibodies were found to be additive in the random effects model.ConclusionsAnti-CarP antibodies are associated with increased disability and higher disease activity in patients with IP. Our results suggest that measurement of anti-CarP antibodies may be useful in identifying ACPA-negative patients with worse long-term outcomes. Further, anti-CarP antibody status provided additional information about RF and ACPA.

scholarly journals One-Year Outcomes with Once or Twice Daily Enoxaparin

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 4968-4968
Author(s):  
Adi J. Klil-Drori ◽  
Sara Nazha ◽  
Marlene Gharib ◽  
Sylvie Perreault ◽  
Vicky Tagalakis
Keyword(s):  
Cohort Study ◽  
Major Bleeding ◽  
Research Funding ◽  
Population Based ◽  
Long Term Outcomes ◽  
Once Daily ◽  
Intention To Treat ◽  
One Year

Background: Enoxaparin given once daily (QD) for thrombotic disorders is less burdensome than twice-daily (BID) dosing. However, long-term outcomes when enoxaparin given as QD monotherapy are unknown. Methods: We did a population-based cohort study. New users of enoxaparin alone (2005-2014) were identified in the linked healthcare databases of Quebec, Canada, and followed up for up to one year. The number of dispensed syringes divided by prescription length determined QD or BID enoxaparin by intention to treat. Cumulative rates of major bleeding and re-treatment with anticoagulants at one year were compared between enoxaparin groups. Re-treatment was initiation of anticoagulation after at least 30 days of no dispensed anticoagulants. The duration of enoxaparin monotherapy was the sum of prescriptions until discontinuation. Results: The cohort included 504 patients; QD and BID enoxaparin users were 445 and 59, respectively. Mean (SD) age was 78.0 (6.6) years, 43.8% were males, and 61.9% had cancer. At 12 months, major bleeding occurred in 21 (4.7%) and 4 (6.8%) among QD and BID enoxaparin users, respectively (Figure 1A, P = 0.49). Re-treatment with anticoagulants occurred in 37 (9.6%) and 5 (9.4%) of QD and BID users, respectively (Figure 1B, P = 0.98). The duration of enoxaparin monotherapy was on average 13.9 (95% CI, 4.4-23.4, P = 0.005) days longer with QD vs BID use. Conclusions: Monotherapy with QD enoxaparin was common and longer than BID enoxaparin with no apparent differences in bleeding or re-treatment with anticoagulants. Figure 1 Disclosures Klil-Drori: Sanofi Canada: Research Funding. Nazha:Sanofi Canada: Employment. Gharib:Sanofi Canada: Employment. Perreault:Sanofi Canada: Research Funding. Tagalakis:Servier: Other: participated on ad boards; Bayer: Other: participated on ad boards; Pfizer: Other: participated on ad boards; Sanofi Aventis: Other: investigator initiated grant;participated on ad boards; BMS-Pfizer: Other: participated on ad boards.

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