An algorithm for tailoring pharmacotherapy for smoking cessation: results from a Delphi panel of international experts
2009

Tailoring Smoking Cessation Pharmacotherapy

Sample size: 37 publication Evidence: high

Author Information

Author(s): Bader P, McDonald P, Selby P

Primary Institution: Centre for Addiction and Mental Health

Hypothesis

Can decision rules be developed to guide clinicians in prescribing pharmacotherapy for smoking cessation?

Conclusion

An algorithm and guide were developed to assist clinicians in prescribing pharmacotherapy for smoking cessation.

Supporting Evidence

  • Pharmacotherapy generally doubles the odds of quitting successfully.
  • Combining pharmacotherapy and psychosocial treatments increases quit rates.
  • A Cochrane review concluded that all types of NRT increased the odds of quitting by approximately one-and-a-half to twofold.
  • Bupropion and nortriptyline were found to double the odds of cessation when prescribed as monotherapy.
  • Varenicline has demonstrated therapeutic superiority over existing first-line medications.

Takeaway

Doctors can use a new guide to help smokers choose the best medicine to quit smoking, based on their needs and experiences.

Methodology

A Delphi approach was used to build consensus among a panel of 37 international experts through three rounds of questionnaires.

Potential Biases

Potential conflicts of interest were present among panelists, but did not appear to affect recommendations.

Limitations

Not all panelists had equal access to the range of pharmacotherapy reviewed, and the study may need updates due to recent safety concerns regarding varenicline.

Participant Demographics

The panel comprised health practitioners and researchers from 13 countries, with 29 males and 8 females.

Statistical Information

P-Value

p<0.001

Statistical Significance

p<0.001

Digital Object Identifier (DOI)

10.1136/tc.2008.025635

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