National Trends in Smoking Cessation Medication Prescriptions for Smokers With Chronic Obstructive Pulmonary Disease in the United States, 2007-2012
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Objectives: Smoking cessation decreases morbidity and mortality due to chronic obstructive pulmonary disease (COPD). Pharmacotherapy for smoking cessation is highly effective. However, the optimal prescription rate of smoking cessation medications among smokers with COPD has not been systemically studied. The purpose of this study was to estimate the national prescription rates of smoking cessation medications among smokers with COPD and to examine any disparities therein. Methods: We conducted a retrospective study using National Ambulatory Medical Care Survey data from 2007 to 2012. We estimated the national prescription rate for any smoking cessation medication (varenicline, bupropion, and nicotine replacement therapy) each year. Multiple survey logistic regression was performed to characterize the effects of demographic variables and comorbidities on prescriptions. Results: The average prescription rate of any smoking cessation medication over 5 years was 3.64%. The prescription rate declined each year, except for a slight increase in 2012: 9.91% in 2007, 4.47% in 2008, 2.42% in 2009, 1.88% in 2010, 1.46% in 2011, and 3.67% in 2012. Hispanic race and depression were associated with higher prescription rates (odds ratio [OR], 5.15; 95% confidence interval [CI], 1.59 to 16.67 and OR, 2.64; 95% CI, 1.26 to 5.51, respectively). There were no significant differences according to insurance, location of the physician, or other comorbidities. The high OR among Hispanic population and those with depression was driven by the high prescription rate of bupropion. Conclusions: The prescription rate of smoking cessation medications among smokers with COPD remained low throughout the study period. Further studies are necessary to identify barriers and to develop strategies to overcome them.
Abstract
Objectives: Smoking cessation decreases morbidity and mortality due to chronic obstructive pulmonary disease (COPD). Pharmacotherapy for smoking cessation is highly effective. However, the optimal prescription rate of smoking cessation medications among smokers with COPD has not been systemically studied. The purpose of this study was to estimate the national prescription rates of smoking cessation medications among smokers with COPD and to examine any disparities therein. Methods: We conducted a retrospective study using National Ambulatory Medical Care Survey data from 2007 to 2012. We estimated the national prescription rate for any smoking cessation medication (varenicline, bupropion, and nicotine replacement therapy) each year. Multiple survey logistic regression was performed to characterize the effects of demographic variables and comorbidities on prescriptions. Results: The average prescription rate of any smoking cessation medication over 5 years was 3.64%. The prescription rate declined each year, except for a slight increase in 2012: 9.91% in 2007, 4.47% in 2008, 2.42% in 2009, 1.88% in 2010, 1.46% in 2011, and 3.67% in 2012. Hispanic race and depression were associated with higher prescription rates (odds ratio [OR], 5.15; 95% confidence interval [CI], 1.59 to 16.67 and OR, 2.64; 95% CI, 1.26 to 5.51, respectively). There were no significant differences according to insurance, location of the physician, or other comorbidities. The high OR among Hispanic population and those with depression was driven by the high prescription rate of bupropion. Conclusions: The prescription rate of smoking cessation medications among smokers with COPD remained low throughout the study period. Further studies are necessary to identify barriers and to develop strategies to overcome them.
참고문헌 (20)
- "The top 10 causes of death"[URL]
- "Morbidity and mortality: 2012 chart book on cardiovascular, lung and blood diseases"[URL]
- Raherison C, "Epidemiology of COPD", Eur Respir Rev, 18(114), pp.213~221 (2009)[DOI]
- Dalal AA, "Direct costs of chronic obstructive pulmonary disease among managed care patients", Int J Chron Obstruct Pulmon Dis, 5, pp.341~349 (2010)
- Darnell K, "Disproportionate utilization of healthcare resources among veterans with COPD: a retrospective analysis of factors associated with COPD healthcare cost", Cost Eff Resour Alloc, 11, pp.13~ (2013)[DOI]
- Crisafulli E, "Role of comorbidities in a cohort of patients with COPD undergoing pulmonary rehabilitation", Thorax, 63(6), pp.487~492 (2008)[DOI]
- Godtfren NS, "COPD-related morbidity and mortality after smoking cessation: status of the evidence", Eur Respir J, 32(4), pp.844~853 (2008)[DOI]
- Tashkin DP, "Effects of varenicline on smoking cessation in patients with mild to moderate COPD: a randomized controlled trial", Chest, 139(3), pp.591~599 (2011)[DOI]
- Rigotti NA, "Smoking cessation interventions for hospitalized smokers: a systematic review", Arch Intern Med, 168(18), pp.1950~1960 (2008)[DOI]
- Fiore MC, "Treating tobacco use and dependence: 2008 update. Rockville: US Department of Health and Human Services", Public Health Service, pp.106~124 (2008)
- Cahill K, "Pharmacological interventions for smoking cessation: an overview and network meta-analysis", Cochrane Database Syst Rev, (5) (2013)
- Anthenelli RM, "Neuropsychiatric safety and efficacy of varenicline, bupropion, and nicotine patch in smokers with and without psychiatric disorders (EAGLES): a double-blind, randomised, placebo-controlled clinical trial", Lancet, 387(10037), pp.2507~2520 (2016)[DOI]
- Tonnesen P, "Smoking cessation and COPD", Eur Respir Rev, 22(127), pp.37~43 (2013)[DOI]
- Melzer AC, "Predictors of pharmacotherapy for tobacco use among Veterans admitted for COPD: the role of disparities and tobacco control processes", J Gen Intern Med, 31(6), pp.623~629 (2016)[DOI]
- Vaidya V, "Utilization of smoking-cessation pharmacotherapy among chronic obstructive pulmonary disease (COPD) and lung cancer patients", Curr Med Res Opin, 30(6), pp.1043~1050 (2014)[DOI]
- Jarlenski M, "Trends in use of medications for smoking cessation in medicare, 2007-2012", Am J Prev Med, 51(3), pp.301~308 (2016)[DOI]
- Melzer AC, "Utilization and effectiveness of pharmacotherapy for tobacco use following admission for exacerbation of COPD", J Hosp Med, 11(4), pp.257~263 (2016)[DOI]
- 김미작, "보건소 금연클리닉 금연성공자의 1년내 재흡연과 관련요인", 예방의학회지, 44(2), pp.84~92 (2011), 대한예방의학회
- "Ambulatory health care data"[URL]
- "FDA Drug Safety Communication: FDA revises description of mental health side effects of the stop-smoking medicines Chantix (varenicline) and Zyban (bupropion) to reflect clinical trial findings" (2015)[URL]