چکیده (انگلیسی):

Background:Guidance in England and Wales recommends that nicotine replacement therapies (NRTs), varenicline or
bupropion should be offered for smoking cessation support. Research on general practitioner (GP) NRT prescribing
patterns for smoking cessation is lacking in the published literature.
Methods:UK primary care electronic health records were retrospectively analysed to identify the most common GP
initiated NRT prescribing patterns, characterise people who receive NRT and determine whether NRTs given in a first
quit attempt are different from subsequent attempts.
Results:The study population comprised 38,954individuals in UK primary care data with a first ever NRT patch smoking
cessation attempt for the period January 2008-December 2011. The majority (64.3%) received NRT patch monotherapy at
first smoking cessation attempt, and the most common NRT was 21 mg/24 hours patch monotherapy (15.2%). Of the
35.7% first smoking cessation attempts which were NRT combination therapy, the most common combination was
patch + inhalator (56.2%). The proportion of people who started a smoking cessation attempt with combination therapy
increased from 25.7% in 2008 to 44.8% in 2011. The majority of the population had one recorded smoking cessation
attempt but a significant minority (20.2% N = 7,868) started a second smoking cessation attempt. Second and third
attempts, while predominantly patch monotherapy, also demonstrated an increasing use of NRT combinations over
the study period (2
nd
episode: 20.6%-38.2%; 3
rd
episode: 20.0%-36.8%). However, a minority received only non-patch
NRT during second and third NRT episodes. Taking into account the 39,068 people prescribed NRT patch during the
study period with a history of NRT at baseline (excluded from the analysis), the total proportion of people prescribed
NRT patch between 2008–2011 who had more than one NRT episode was 48.4% (46,936/96,986) and of 128,115 NRT
users, only 14.7% (N = 18,838) were prescribed bupropion or varenicline prior to NRT use.
Conclusions:The study findings represent new data describing GP NRT prescription patterns in the UK. Given the
predominance of NRT patch monotherapy observed, health policy makers and service commissioners should ensure
that GPs provide equality of access to all recommended smoking cessation pharmacotherapies.