A meta‐ethnography of adult smokers’ exploring the meanings of tobacco dependency medications adherence behaviours during smoking cessation

• Published in: Journal of advanced nursing Vol. 75; no. 12; pp. 3286 - 3298
• Main Authors: Sanders, Carol Jane, Lindenmeyer, Antje, Marriott, John
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01-12-2019
• Subjects: Adherence; Adults; Anthropology, Cultural; Clinical medicine; Clinical practice guidelines; Dependency; Disability; Drugs; Ethnography; Health care policy; Health education; Health information; Humans; Intervention; Medical personnel; Medication Adherence; Meta-analysis; nursing assessment; Patient compliance; Psychosocial factors; Public health; public health nursing; qualitative approaches; Qualitative research; smoking; Smoking cessation; Smoking Cessation - methods; Substance abuse treatment; Systematic review; systematic reviews and meta‐analyses; Tobacco; Tobacco Use Disorder; qualitative approaches; medication adherence; systematic reviews and meta-analyses; nursing assessment; public health nursing; smoking
• DOI: 10.1111/jan.14146
• EISSN: 1365-2648
• ISSN: 0309-2402

Aims
To synthesize the experiences and adherence of adult smokers’ with tobacco dependence medications.
Design
Meta‐ethnography.
Data sources
Seven bibliographic databases were systematically searched until April 2016.
Review Methods
A standardized appraisal tool evaluated the quality of the selected studies.
Results
Seven studies met the eligibility criteria. Three major themes described the experiences and adherence of adult smokers’ with tobacco dependence medications; the psychosocial context, predilection for willpower and “natural” methods and a tendency to resist medications.
Conclusion
The findings of this meta‐ethnography are important to future clinical practice guideline development so health professionals contribute effectively to further reduction in smoking prevalence. Further research is needed to understand resistance to tobacco dependence medications and to inform the design of person‐tailored interventions to improve tobacco dependence medication adherence that can be incorporated into smoking cessation interventions.
Impact
Smoking causes more death and disability in the world than any other avoidable factor. Research on smoker perspectives on tobacco dependence medications is sparse. Tobacco dependency is a unique treatment context with specific adherence issues. Smokers are active decision‐makers regarding tobacco dependence medications. Inconsistent adherence to tobacco dependency medication regimens was apparent. Implications for health professionals, healthcare policy and clinical practice guidelines regard the structure of consultations with smoking patients. It is critical for all health professionals to assess the person seeking to stop smoking and foresee the possible causes of non‐adherence behaviour. Addressing non‐adherence will to lead to more effective health communications and positively contribute to quality of smoking cessation care.
目的
总结成年吸烟者使用烟草依赖性治疗药物的经验和遵从性。
设计
人口学荟萃分析。
资料来源
截至2016年4月,共对7个书目数据库进行了系统性检索。
综述方法
评估所选研究的质量的标准化评估工具。
结果
7项研究符合资格标准。三大专题说明了成年吸烟者使用烟草依赖性治疗药物的经验和遵从性;社会心理背景、对意志力与“自然”方法的偏爱以及抗拒治疗药物的倾向。
结论
此次人口学荟萃分析的调查结果对今后临床实践指南的制定具有重要意义,医护专业人员可以为进一步降低吸烟率做出有效贡献。需要开展进一步的研究,以了解对烟草依赖性治疗药物的抗药性,并为个性化干预措施的设计提供信息,以提高可纳入戒烟干预措施的烟草依赖性治疗药物遵从性。
影响
在世界上,与任何其他可避免因素相比,因吸烟造成的死亡和残疾情况更多。关于吸烟者对烟草依赖性治疗药物的看法的研究很少。烟草依赖性是一种独特的治疗环境,具有特定的遵从性问题。吸烟者是烟草依赖性治疗药物的积极政策制定者。不能完全遵从烟草依赖性治疗药物方案,这是明显的。对医护专业人员、医护服务政策和临床实践指南的影响涉及与吸烟患者进行沟通的结构。所有医护专业人员都必须对寻求戒烟的人进行评估,并预见不依从行为的可能原因。解决不依从问题,将促成更有效的健康宣传,可对戒烟护理的质量作出积极贡献。