약사 제공 금연 중재서비스의 효과 비교

Comparative Effectiveness of Smoking Cessation Intervention with Pharmacist-delivered Service: Systematic Review and Bayesian Network Meta-analysis

OBJECTIVES This study aims to estimate and compare the smoking cessation rate of pharmacist-delivered support with nicotine replacement therapy (hereafter, pharmacist support + NRT) by conducting a systematic review and Bayesian network meta-analysis (BNMA). METHODS We systematically reviewed the articles, which reported the smoking cessation rate for 1) pharmacist support + NRT, 2) varenicline with non-pharmacist support, 3) NRT with non-pharmacist support to identify the relevant studies. Searched studies from Pubmed and Cochrane library were selected according to the pre-defined inclusion/exclusion criteria. We extracted the smoking cessation rate at 6 months from included studies. This BNMA estimated the posterior average smoking cessation rate at 6 months and the corresponding 95% credible interval (CrI). We conducted the BNMA by using WinBUGS 1.4.3. RESULTS After comprehensive systematic review, we finally selected and included 33 studies in BNMA. Average smoking cessation rate at 6 months was the lowest for placebo (16.6%; 95% CrI=15.4%-17.8%) as followed by NRT + non-pharmacist support (28.5%; 95% CrI=23.0%-34.7%), pharmacist support + NRT (36.1%; 95% CrI=25.1%-48.8%), and varenicline + non-pharmacist support (37.7%; 95% CrI=32.0%- 44.1%]. CONCLUSION In this study, we estimated the smoking cessation rate of pharmacist service with NRT, NRT and varenicline, respectively. We expect that the results of this study will be used as a useful evidence for establishing policies for various types of smoking cessation services.