RESUMO
Counseling and pharmacotherapy are smoking cessation interventions whose effectiveness has been widely demonstrated. Different pharmacologic treatment options exist with similar efficacy : notably nicotine replacement therapy, varenicline and bupropion. Providers can promote therapeutic adherence and the chances of successful quitting by involving patients in the choice of medication and incorporating their preferences in the decision process. The concept of shared decision-making is based on an exchange between doctor and patient in medical situations with several reasonable options. Decision aids support this approach by facilitating the transmission of information, communication and patient involvement. Despite opportunities for shared decision-making during the smoking cessation process, few decision aids are available. This article summarizes current knowledge in this field and its application to the process of smoking cessation. Shared decision making in smoking cessation is illustrated by a decision aid created to facilitate the choice between different smoking cessation medications.
Assuntos
Comportamento de Escolha/fisiologia , Tomada de Decisão Compartilhada , Participação do Paciente/métodos , Abandono do Hábito de Fumar/métodos , Bupropiona/uso terapêutico , Aconselhamento , Humanos , Nicotina/uso terapêutico , Participação do Paciente/psicologia , Participação do Paciente/estatística & dados numéricos , Seleção de Pacientes , Abandono do Hábito de Fumar/psicologia , Dispositivos para o Abandono do Uso de Tabaco , Vareniclina/uso terapêuticoRESUMO
A Swiss private company decided to launch a healthy lifestyle-oriented medical visit for its employees. Participating general practitioners had prior training through a one-day course. A brief physical examination, cholesterol and glucose analyses were included in the consultation. Half of the employees participated in the project. Health habits were similar to the general Swiss population. Four months later, 61% reported having changed at least one lifestyle health habit in order to improve their health. Most of participants and practitioners were satisfied with this type of consultation, that confirms the interest and the feasibility of such a project.