Strategies for smoking cessation (pharmacologic intervention versus enhanced motivation vs. standard motivation) in TB patients under treatment in the RNTCP, India - A cluster - Randomized trial.


Journal

The Indian journal of tuberculosis
ISSN: 0019-5707
Titre abrégé: Indian J Tuberc
Pays: India
ID NLM: 0373027

Informations de publication

Date de publication:
Jan 2020
Historique:
received: 02 08 2019
revised: 16 10 2019
accepted: 09 01 2020
entrez: 21 3 2020
pubmed: 21 3 2020
medline: 5 1 2021
Statut: ppublish

Résumé

Tuberculosis burden is still high and smoking prevalence among males has increased in India. It is found that increased morbidity, mortality and relapse among TB smokers. Setting: Patients from two Revised National Tuberculosis Control Program Centres of Tamilnadu form the study population. To compare the effectiveness of Bupropion therapy along with standard counselling versus enhanced counseling versus standard counseling for smoking cessation among TB patients. Cluster randomized effectiveness trial. Patients from each of the thirty-six Designated Microscopic Centres were randomly allocated to receive one of the three interventions using cluster randomization. Smoking cessation was assessed by self-reporting and confirmed by Carbon monoxide(CO) monitors, done at three-time points and TB treatment outcome at the end of ATT. Out of 517 male patients enrolled to the study, the smoking status is available only to 381 subjects. The proportion of patients who have quit smoking in drug, enhanced and standard arms at the end of treatment was 67%, 83% and 52% (P= < 0.001). There was no statistical significance in response to TB treatment between those who quit and those who did not (Favourable response 99.2% vs 97.6%). Both enhanced counselling arm and drug arm are effective strategies for smoking cessation among TB patients and their implementation in the TB programs are recommended.

Sections du résumé

BACKGROUND BACKGROUND
Tuberculosis burden is still high and smoking prevalence among males has increased in India. It is found that increased morbidity, mortality and relapse among TB smokers.
METHOD METHODS
Setting: Patients from two Revised National Tuberculosis Control Program Centres of Tamilnadu form the study population.
OBJECTIVE OBJECTIVE
To compare the effectiveness of Bupropion therapy along with standard counselling versus enhanced counseling versus standard counseling for smoking cessation among TB patients.
STUDY DESIGN METHODS
Cluster randomized effectiveness trial.
PROCEDURE METHODS
Patients from each of the thirty-six Designated Microscopic Centres were randomly allocated to receive one of the three interventions using cluster randomization. Smoking cessation was assessed by self-reporting and confirmed by Carbon monoxide(CO) monitors, done at three-time points and TB treatment outcome at the end of ATT.
RESULTS RESULTS
Out of 517 male patients enrolled to the study, the smoking status is available only to 381 subjects. The proportion of patients who have quit smoking in drug, enhanced and standard arms at the end of treatment was 67%, 83% and 52% (P= < 0.001). There was no statistical significance in response to TB treatment between those who quit and those who did not (Favourable response 99.2% vs 97.6%).
CONCLUSION CONCLUSIONS
Both enhanced counselling arm and drug arm are effective strategies for smoking cessation among TB patients and their implementation in the TB programs are recommended.

Identifiants

pubmed: 32192623
pii: S0019-5707(20)30006-8
doi: 10.1016/j.ijtb.2020.01.006
pii:
doi:

Substances chimiques

Antitubercular Agents 0
Smoking Cessation Agents 0
Bupropion 01ZG3TPX31

Types de publication

Journal Article Randomized Controlled Trial

Langues

eng

Sous-ensembles de citation

IM

Pagination

8-14

Informations de copyright

Copyright © 2020 Tuberculosis Association of India. Published by Elsevier B.V. All rights reserved.

Auteurs

S Ramesh Kumar (S)

Dept. of Clinical Research, ICMR-National Institute for Research in Tuberculosis, Madurai Unit, India. Electronic address: drrameshskumar@yahoo.co.in.

Chandrakumar Dolla (C)

Dept. of Epidemiology, ICMR-National Institute for Research in Tuberculosis, Chennai, India.

M Vasantha (M)

Dept. of Statistics, ICMR-National Institute for Research in Tuberculosis, Chennai, India.

Pradeep Aravinda Menon (PA)

Dept. of Epidemiology, ICMR-National Institute for Research in Tuberculosis, Chennai, India.

G Venkatesan (G)

Dept. of Socio Behavioral Research, ICMR-National Institute for Research in Tuberculosis, Chennai, India.

P Venkatesan (P)

Dept. of Statistics, ICMR-National Institute for Research in Tuberculosis, Chennai, India.

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Classifications MeSH