OBJECTIVE: Assessment of the feasibility and effectiveness of a brief intervention for smoking cessation in people living with HIV (PLWH). SETTING: Multicenter cohort prospective study involving PLWH from ten Italian Infectious Disease Centers. METHODS: During routine HIV care, clinicians delivered 5As brief intervention (Ask, Advise, Assess, Assist, Arrange) to each patient who entered to the study, following the European AIDS Clinical Society guidelines. At study end, participating clinicians evaluated their own adherence to intervention: "standard" if counseling was delivered in at least half of the follow-up visits, "soft" if less. The main outcome measure was smoking abstinence ≥6 months. Abstinence predictors were evaluated using a Cox-proportional hazard regression model. RESULTS: 1,087 PLWH-patients (age 47.9±10.8, male 73.5%) were followed for a median of 23 months (IQR 21-25). At baseline, current smokers were 561 (51.6%). Standard intervention was performed in four out of ten centers and included 343 smokers; soft intervention was performed in 6 centers (218 smokers). At last visit 35 patients in standard (10.8%) and 6 in soft intervention (2.8%) achieved self-reported tobacco abstinence ≥6 months (p=0.0009). Overall, the 5As intervention led to 7.3% 6-month interruptions. In the multivariable analysis, significant predictors for 6-month smoking cessation were: lower Fagerström-score, stage of change (preparation/contemplation vs. pre-contemplation), and standard intervention. CONCLUSION: Adherence to 5As brief intervention emerged as a critical factor for success. In fact, as compared to soft intervention, the standard intervention significantly increased abstinence, highlighting that clinicians need more time and supporting tools to encourage PLWH to quit smoking.

Is it feasible to impact on smoking habits in HIV-Infected patients? Mission impossible from the STOPSHIV Project cohort / De Socio, Giuseppe Vittorio; Ricci, Elena; Maggi, Paolo; Orofino, Giancarlo; Squillace, Nicola; Menzaghi, Barbara; Madeddu, Giordano; Di Biagio, Antonio; Francisci, Daniela; Bonfanti, Paolo; Vichi, Francesca; dell'Omo, Marco. - In: JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES. - ISSN 1525-4135. - 83:5(2020), pp. 496-503. [10.1097/QAI.0000000000002284]

Is it feasible to impact on smoking habits in HIV-Infected patients? Mission impossible from the STOPSHIV Project cohort

Madeddu, Giordano;
2020

Abstract

OBJECTIVE: Assessment of the feasibility and effectiveness of a brief intervention for smoking cessation in people living with HIV (PLWH). SETTING: Multicenter cohort prospective study involving PLWH from ten Italian Infectious Disease Centers. METHODS: During routine HIV care, clinicians delivered 5As brief intervention (Ask, Advise, Assess, Assist, Arrange) to each patient who entered to the study, following the European AIDS Clinical Society guidelines. At study end, participating clinicians evaluated their own adherence to intervention: "standard" if counseling was delivered in at least half of the follow-up visits, "soft" if less. The main outcome measure was smoking abstinence ≥6 months. Abstinence predictors were evaluated using a Cox-proportional hazard regression model. RESULTS: 1,087 PLWH-patients (age 47.9±10.8, male 73.5%) were followed for a median of 23 months (IQR 21-25). At baseline, current smokers were 561 (51.6%). Standard intervention was performed in four out of ten centers and included 343 smokers; soft intervention was performed in 6 centers (218 smokers). At last visit 35 patients in standard (10.8%) and 6 in soft intervention (2.8%) achieved self-reported tobacco abstinence ≥6 months (p=0.0009). Overall, the 5As intervention led to 7.3% 6-month interruptions. In the multivariable analysis, significant predictors for 6-month smoking cessation were: lower Fagerström-score, stage of change (preparation/contemplation vs. pre-contemplation), and standard intervention. CONCLUSION: Adherence to 5As brief intervention emerged as a critical factor for success. In fact, as compared to soft intervention, the standard intervention significantly increased abstinence, highlighting that clinicians need more time and supporting tools to encourage PLWH to quit smoking.
Is it feasible to impact on smoking habits in HIV-Infected patients? Mission impossible from the STOPSHIV Project cohort / De Socio, Giuseppe Vittorio; Ricci, Elena; Maggi, Paolo; Orofino, Giancarlo; Squillace, Nicola; Menzaghi, Barbara; Madeddu, Giordano; Di Biagio, Antonio; Francisci, Daniela; Bonfanti, Paolo; Vichi, Francesca; dell'Omo, Marco. - In: JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES. - ISSN 1525-4135. - 83:5(2020), pp. 496-503. [10.1097/QAI.0000000000002284]
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11388/231595
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