Helping smokers with cardiac disease to abstain from tobacco after a stay in hospital [Comment]

Tobacco Research and Treatment Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
Canadian Medical Association Journal (Impact Factor: 5.96). 07/2009; 180(13):1283-4. DOI: 10.1503/cmaj.090729
Source: PubMed
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    • "Intensive smoking cessation interventions are, in general, recommended to cover the need for new (cost-)effective interventions for smoking cardiac patients [11,28]. Evidence suggests that interventions combining personalised behavioural counselling with pharmacological treatment are most likely to increase quitting rates in hospitalised (cardiac) patients [11,29-33]. "
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    ABSTRACT: There is no more effective intervention for secondary prevention of coronary heart disease than smoking cessation. Yet, evidence about the (cost-)effectiveness of smoking cessation treatment methods for cardiac inpatients that also suit nursing practice is scarce. This protocol describes the design of a study on the (cost-)effectiveness of two intensive smoking cessation interventions for hospitalised cardiac patients as well as first results on the inclusion rates and the characteristics of the study population. An experimental study design is used in eight cardiac wards of hospitals throughout the Netherlands to assess the (cost-)effectiveness of two intensive smoking cessation counselling methods both combined with nicotine replacement therapy. Randomization is conducted at the ward level (cross-over). Baseline and follow-up measurements after six and 12 months are obtained. Upon admission to the cardiac ward, nurses assess patients' smoking behaviour, ensure a quit advice and subsequently refer patients for either telephone counselling or face-to-face counselling. The counselling interventions have a comparable structure and content but differ in provider and delivery method, and in duration. Both counselling interventions are compared with a control group receiving no additional treatment beyond the usual care. Between December 2009 and June 2011, 245 cardiac patients who smoked prior to hospitalisation were included in the usual care group, 223 in the telephone counselling group and 157 in the face-to-face counselling group. Patients are predominantly male and have a mean age of 57 years. Acute coronary syndrome is the most frequently reported admission diagnosis. The ultimate goal of the study is to assess the effects of the interventions on smoking abstinence and their cost-effectiveness. Telephone counselling is expected to be more (cost-)effective in highly motivated patients and patients with high SES, whereas face-to-face counselling is expected to be more (cost-)effective in less motivated patients and patients with low SES. This study examines two intensive smoking cessation interventions for cardiac patients using a multi-centre trial with eight cardiac wards. Although not all eligible patients could be included and the distribution of patients is skewed in the different groups, the results will be able to provide valuable insight into effects and costs of counselling interventions varying in delivery mode and intensity, also concerning subgroups. Dutch Trial Register NTR2144.
    BMC Cardiovascular Disorders 05/2012; 12(1):33. DOI:10.1186/1471-2261-12-33 · 1.88 Impact Factor
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    • "Un ajustement du dosage ou un changement de traitement pharmacologique aurait pourtant pu leur être bénéfique. Qui plus est, la littérature suggère qu'associée à un traitement médicamenteux, une prise en charge psychosociale du sevrage augmenterait les chances de succès chez les patients coronariens comme c'est le cas dans la population générale de fumeurs [6]. Dans notre échantillon, une prise en charge cognitivo-comportementale aurait été utile pour ceux ayant poursuivi le tabagisme. "
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    ABSTRACT: Aim of the studyTo offer routine information on smoking cessation and bedside counseling to smokers admitted in cardiac intensive care unit. The objective is to encourage cessation and/or use of smoking cessation services after discharge.
    Annales de Cardiologie et d Angéiologie 08/2011; 60(4):189-196. DOI:10.1016/j.ancard.2011.05.006 · 0.30 Impact Factor
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    ABSTRACT: The 2'-hydroxyl group plays an integral role in RNA structure and catalysis. This ubiquitous component of the RNA backbone can participate in multiple interactions essential for RNA function, such as hydrogen bonding and metal ion coordination, but the multifunctional nature of the 2'-hydroxyl renders identification of these interactions a significant challenge. By virtue of their versatile physicochemical properties, such as distinct metal coordination preferences, hydrogen bonding properties, and ability to be protonated, 2'-amino-2'-deoxyribonucleotides can serve as tools for probing local interactions involving 2'-hydroxyl groups within RNA. The 2'-amino group can also serve as a chemoselective site for covalent modification, permitting the introduction of probes for investigation of RNA structure and dynamics. In this chapter, we describe the use of 2'-aminonucleotides for investigation of local interactions within RNA, focusing on interactions involving 2'-hydroxyl groups required for RNA structure, function, and catalysis.
    Methods in enzymology 01/2009; 468:107-25. DOI:10.1016/S0076-6879(09)68006-X · 2.09 Impact Factor
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