scholarly journals Triple Smoking Cessation Therapy with Varenicline, Nicotine Patch and Nicotine Lozenge: A Pilot Study to Assess Tolerability, Satisfaction and End-of-Treatment Quit Rates

2017 ◽  
Vol 13 (3) ◽  
pp. 145-153
Author(s):  
Kristin M. Berg ◽  
Douglas E. Jorenby ◽  
Timothy B. Baker ◽  
Michael C. Fiore
Keyword(s):  
Observational Study ◽  
Triple Therapy ◽  
Additional Data ◽  
Nicotine Patch ◽  
Stop Smoking ◽  
End Of Treatment ◽  
Nicotine Lozenge ◽  
Satisfaction Rates ◽  
Medication Changes ◽  
Smoking Cessation Therapy

Introduction: The majority of attempts to stop smoking end in failure. One way to improve success may be to explore different combinations of existing cessation medications.Aims: This observational study examined ‘triple therapy’ (varenicline + nicotine patch + nicotine lozenge) in 36 smokers trying to quit.Methods: A 12-week, observational study exploring tolerability, via adverse events (AEs) elicited at each of nine phone assessments. Secondary outcomes included satisfaction rates, medication changes and self-reported quit rates at week 12.Results: Thirty five of thirty six participants reported at least one AE. Insomnia (75%), abnormal dreams (72%) and nausea (64%) were most common. Most were mild to moderate. No deaths, hospitalisations, cardiovascular events or suicidality were reported. Six participants (17%) decreased the dose of at least one medication, 5 (14%) decreased the dose then discontinued at least one medication and 13 (36%) discontinued at least one medication without trying a lesser dose. Participants were highly satisfied with their medications, and 58% reported quitting at 12 weeks, with 38% reporting prolonged abstinence.Conclusions: Despite high rates of AEs and medication changes, high rates of satisfaction and self-reported quitting, with no serious AEs, were observed with triple therapy. Additional data on tolerability and efficacy are needed.Trial Registration:Clinicaltrials.gov number NCT02681510.

scholarly journals Preventable adverse drug events causing hospitalisation: identifying root causes and developing a surveillance and learning system at an urban community hospital, a cross-sectional observational study

2021 ◽  
Vol 10 (1) ◽  
pp. e001161
Author(s):  
Jane de Lemos ◽  
Peter Loewen ◽  
Cheryl Nagle ◽  
Robert McKenzie ◽  
Yong Dong You ◽  
...  
Keyword(s):  
Observational Study ◽  
Adverse Drug Events ◽  
Healthcare Providers ◽  
Medication Use ◽  
Learning System ◽  
Chronic Obstructive ◽  
Action Plans ◽  
Medical Conditions ◽  
Cross Sectional ◽  
Medication Changes

ObjectivesTo identify root causes of preventable adverse drug events (pADEs) contributing to hospital admission; to develop key messages which identify actions patients/families and healthcare providers can take to prevent common pADEs found; to develop a surveillance learning system for the community.MethodsCross-sectional observational study; 120 patients and families, 61 associated healthcare providers were interviewed then root cause analysis was performed to develop key learning messages and an electronic reporting tool was designed. Most common pADE-related medical conditions and their root causes and most common pADE root causes of entire cohort are reported.ResultsMost common pADE-related medical conditions: chronic obstructive pulmonary disease/asthma (13.3%), bleeding (12.5%), hypotension (12%), heart failure (10%), acute kidney injury (5%) and pneumonia (5%). Most common root causes were: providers not confirming that the patient/family understands information given (29.2%), can identify how a medication helps them/have their concerns addressed (16.7%), can identify if a medication is working (14.1%) or causing a side effect (23.3%); can enact medication changes (7.5%); absence of a sick day management plan (12.5%), and other action plans to help patients respond to changes in their clinical status (10.8%); providers not assessing medication use and monitoring competency (19.2%). Ten key learning messages were developed and a pADE surveillance learning system was implemented.ConclusionsTo prevent pADEs, providers need to confirm that patients/families understand information given, how a medication helps them, how to recognise and respond to side effects, how to enact medication changes and follow action plans; providers should assess patient’s/families’ medication use and monitoring competency.

scholarly journals Nicotine patch vs. nicotine lozenge for smoking cessation: An effectiveness trial coordinated by the Community Clinical Oncology Program

2010 ◽  
Vol 107 (2-3) ◽  
pp. 237-243 ◽  
Author(s):  
Robert A. Schnoll ◽  
Elisa Martinez ◽  
Kristina L. Tatum ◽  
Marcella Glass ◽  
Albert Bernath ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Clinical Oncology ◽  
Nicotine Patch ◽  
Effectiveness Trial ◽  
Community Clinical Oncology Program ◽  
Nicotine Lozenge

scholarly journals Out-patient high-dose-rate endobronchial brachytherapy for palliation of lung cancer: an observational study

2016 ◽  
Vol 67 (3) ◽  
Author(s):  
A. Scarda ◽  
M. Confalonieri ◽  
C. Baghiris ◽  
S. Binato ◽  
R. Mazzarotto ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Observational Study ◽  
Dose Rate ◽  
Malignant Tumour ◽  
High Dose Rate ◽  
Advanced Lung Cancer ◽  
High Dose ◽  
End Of Treatment ◽  
Co Morbidity ◽  
Central Airway

Background and Aim. Out-patient high-dose-rate endobronchial brachytherapy (HDREB) is a possible option in the palliation of symptoms in patients with advanced lung cancer, but literature data is limited and the technique is still under development in Italy. Our aim was to evaluate safety and effectiveness of out-patient HDREB for palliation of malignant endobronchial tumours in the context of a multidisciplinary approach. Methods. Out-patient HDREB sessions were scheduled at weekly intervals (500-1000 cGy per session) with prior Diodi-laser resection in some cases. Response was assessed bronchoscopically, clinically and functionally at the end of treatment and one month after the last HDREB session. Inclusion criteria was: histological evidence of malignant tumour not susceptible to surgical treatment for extension or co-morbidity. Results. 150 outpatient HDREB sessions were carried out on consecutive 35 patients (mean age 69 yrs, M/F 29/6) with symptoms due to central airway obstruction. A shortterm endoscopic response was observed in 15/28 patients. After delivering 2000 cGy dyspnoea decreased significantly. After one month cough decreased and haemoptysis disappeared. Palliation was obtained in all patients except one during. Lung function tests did not significantly improve after HDREB. No fatal complication occurred. A temporary radiation bronchitis was observed in six patients. Conclusions. This non-comparative, prospective observational study showed a palliative response of HDREB in most of patients with advanced endoluminal lung cancer. The safety of the procedure was good and the rate of non-fatal serious complications was very low.

scholarly journals Pilot Randomized Controlled Trial of Web-Delivered Acceptance and Commitment Therapy Versus Smokefree.gov for Smokers With Bipolar Disorder

2019 ◽  
Vol 22 (9) ◽  
pp. 1543-1552 ◽  
Author(s):  
Jaimee L Heffner ◽  
Megan M Kelly ◽  
Jeanette Waxmonsky ◽  
Kristin Mattocks ◽  
Edit Serfozo ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Trial Design ◽  
Nicotine Patch ◽  
Controlled Trial ◽  
Web Based ◽  
Randomized Controlled ◽  
Acceptance And Commitment ◽  
End Of Treatment ◽  
Pilot Randomized Controlled Trial

Abstract Introduction Smokers with bipolar disorder (BD) are less successful at quitting than the general population. In this study, we evaluated in a pilot randomized controlled trial a novel, targeted, web-based intervention for smokers with BD based on acceptance and commitment therapy (ACT) and designed for reach and disseminability. Aims and Methods Daily smokers (n = 51) with bipolar I or II disorder were recruited from four US sites and randomly assigned to one of two web-based smoking cessation interventions—ACT-based WebQuit Plus (n = 25) or Smokefree.gov (n = 26) over a 10-week treatment period. All participants received nicotine patch for 8 weeks. Key outcomes were trial design feasibility, intervention acceptability, and cessation at end of treatment and 1-month follow-up. Results We screened 119 to enroll 51 participants (target sample size = 60) over 24 months. The most common reason for ineligibility was the inability to attend study appointments. Retention was 73% at end of treatment and 80% at follow-up, with no differences by arm. The mean number of logins was twice as high for WebQuit Plus (10.3 vs. 5.3). The usefulness of program skills was rated higher for WebQuit Plus (75% vs. 29%). Biochemically confirmed, 7-day abstinence at end of treatment was 12% in WebQuit Plus versus 8% in Smokefree.gov (odds ratio = 1.46, 95% confidence interval = 0.21 to 9.97). At follow-up, abstinence rates were 8% in both arms. Conclusions Trial design produced favorable retention rates, although alternative recruitment methods will be needed for a larger trial. At end of treatment, acceptability and estimated effect size of WebQuit Plus relative to Smokefree.gov were promising and support continued program refinement and evaluation. Implications In this first randomized controlled trial of a targeted intervention for smokers with BD, we found that the ACT-based WebQuit Plus intervention, delivered in combination with the nicotine patch, had promising acceptability and cessation outcomes relative to Smokefree.gov. The observed signals for acceptability and cessation suggest that the WebQuit Plus program should be refined based on participant feedback and evaluated in a larger trial. Feasibility findings from this study also provide direction for refining trial procedures to enhance the recruitment of smokers with BD.

scholarly journals How satisfied are cervical dystonia patients after 3 years of botulinum toxin type A treatment? Results from a prospective, long-term observational study

2019 ◽  
Vol 266 (12) ◽  
pp. 3038-3046 ◽  
Author(s):  
Carlo Colosimo ◽  
◽  
David Charles ◽  
Vijay P. Misra ◽  
Pascal Maisonobe ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Botulinum Toxin ◽  
Observational Study ◽  
Cervical Dystonia ◽  
Treatment Cycle ◽  
Symptom Control ◽  
Type A ◽  
Peak Effect ◽  
End Of Treatment

Abstract Background Patients with cervical dystonia (CD) typically require regular injections of botulinum toxin to maintain symptomatic control. We aimed to document long-term patient satisfaction with CD symptom control in a large cohort of patients treated in routine practice. Methods This was a prospective, international, observational study (NCT01753349) following the course of adult CD treated with botulinum neurotoxin type A (BoNT-A) over 3 years. A comprehensive clinical assessment status was performed at each injection visit and subjects reported satisfaction in two ways: satisfaction with symptom control at peak effect and at the end of treatment cycle. Results Subject satisfaction remained relatively stable from the first to the last injection visit. At 3 years, 89.9% of subjects reported satisfaction with symptom control at peak effect and 55.6% reported satisfaction with symptom control at end of treatment cycle. By contrast, objective ratings of CD severity showed an overall reduction over 3 years. Mean ± SD Toronto Western Spasmodic Rating Scale (TWSTRS) Total scores (clinician assessed at end of treatment cycle) decreased from 31.59 ± 13.04 at baseline to 24.49 ± 12.43 at 3 years (mean ± SD reduction from baseline of − 6.97 ± 11.56 points). Tsui scale scores also showed gradual improvement; the percent of subjects with a tremor component score of 4 reduced from 12.4% at baseline to 8.1% at 3 years. Conclusions Despite objective clinical improvements over 3 years, subject satisfaction with symptom control remained relatively constant, indicating that factors other than symptom control also play a role in patient satisfaction.

Using the Nicotine Patch to Stop Smoking

JAMA ◽  
1995 ◽  
Vol 273 (3) ◽  
pp. 181
Author(s):  
George S. Richardson
Keyword(s):  
Nicotine Patch ◽  
Stop Smoking

scholarly journals Smoking cessation counselling practices of family physicians in Jordan

2013 ◽  
Vol 8 (2) ◽  
pp. 85-90 ◽  
Author(s):  
Mousa Abdullah Alomari ◽  
Yousef Saleh Khader ◽  
Ali Shakir Dauod ◽  
Khaled Adel Abu-Hammour ◽  
Adi Harbi Khassawneh ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Smoking Status ◽  
Nicotine Patch ◽  
Family Physicians ◽  
Smoking Cessation Counselling ◽  
Quit Smoking ◽  
Self Help ◽  
Stop Smoking ◽  
Two Factors ◽  
Structured Questionnaire

Objectives: To assess the smoking cessation counselling practices of family physicians in Jordan and assess their perception about the availability of smoking cessation resources and about the barriers to effective smoking cessation practices. Methods: A pre-structured questionnaire was distributed to 124 family physicians practicing in teaching and Ministry of Health medical centres in Jordan. All participants were asked about their smoking cessation practices and about the barriers to effective smoking cessation practices. Results: Only 39.8% reported that they assess the willingness of the patients to quit smoking and 28.2% reported that they discuss counselling options with smokers. Considerably fewer percentages of physicians reported that they prepare their patients for withdrawal symptoms (11.6%), discuss pharmacotherapies (4.9%), describe a nicotine patch (5.0%), and provide patients with self-help materials (6.7%). The two factors cited most often by physicians as significant barriers to smoking cessation counselling were lack or too few available cessation programmes (90.3%) and limited training for physicians on tobacco and cessation interventions (90.3%). Conclusion: While a high proportion of Jordanian family physicians reported that they usually ask patients about smoking status and advise them to stop smoking, they do not regularly provide extensive assistance to help their patients to quit smoking. Lack or too few available cessation programmes and limited training for physicians on smoking cessation interventions were identified as the two major barriers to effective smoking cessation counselling.

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