Publication: Comparative Effectiveness of Pharmacological Interventions to Prevent Smoking Relapse in Recent Quitters: A Systematic Review with Network Meta-Analysis
| dc.contributor.author | Looi Pooi Ling | |
| dc.date.accessioned | 2023-10-06T15:08:10Z | |
| dc.date.available | 2023-10-06T15:08:10Z | |
| dc.date.issued | 2020 | |
| dc.description.abstract | Introduction: Cigarette smoking kills nearly 8 million people worldwide yearly and in Malaysia, it is estimated at least 20,000people died in a year. Cessation of cigarette smoking is associated with significant health benefits. Although pharmacotherapies can help smokers to quit smoking, rates of smoking relapse remains reasonably high and stays as one of the major health concerns globally. In order to ensure an effective treatment outcome, the health care providers, including pharmacists need to know the effectiveness of the available pharmacological interventions to help quitters remain long term abstinent. This study aims to assess the comparative effectiveness of pharmacological interventions to prevent smoking relapse in recent quitters. Methodology: This research was conducted based on Cochrane methodology and reported as per PRISMA-NMA guideline. Relevant human studies up to 31/10/2019 was searched through databases such as Medlines, Embase, and CENTRAL. Once identified the related RCTs, those relevant data were extracted in a standard data extraction form. RoB tool was used to evaluate the quality of trials. The random effect model was performed for both pairwise meta-analysis and NMA as summary statistics. Publication bias was also assessed sing comparison-adjusted funnel plot. The interventions were then ranked using SUCRA scores. All the above analyses were conducted using STATA software version 15.0. Lastly, GRADE methodology was used to rate the quality of evidence for all included RCTs. Results: This research included a total of ten RCTs involving 7,751 participants with comparing the five major interventions Bupropion (BUP), Nicotine based therapy (NI), combination of nicotine based therapy and bupropion (NI+BUP), Rimonabant (RNB), and Varenicline (VRN)to evaluate the comparative effectiveness for the prevention of smoking relapse. The results from the NMA and pairwise meta-analysis demonstrated that RNB is the most effective relapse prevention intervention according to primary and secondary analysis. It falls under moderate evidence based on GRADE criteria. NI+BUP ranked second with moderate evidence. VRN considered the next most effective pharmacological intervention to reduce smoking relapse, but graded as very low evidence. However, only RNB (RR 1.29 [95%CI, 1.08 –1.55]) and VRN (RR1.22 [95%CI, 1.06 –1.39])shows a statistically significant association in preventing smoking relapse among recent quitters. Conclusion: RNB is the most effective pharmacological agent in smoking relapse prevention. However, due to its unacceptable side effects, including dangerous psychiatric disorders, VRN has been preferred. The extended use of VRN has demonstrated a significant long-term relapse prevention effect and is the most suitable agent to reduce the relapse incidence towards ex-smokers. | en_US |
| dc.identifier.uri | https://hdl.handle.net/20.500.14377/31985 | |
| dc.language.iso | en | en_US |
| dc.publisher | International Medical University | en_US |
| dc.subject | Tobacco Products | en_US |
| dc.subject | Smoking | en_US |
| dc.subject | Drug Therapy | en_US |
| dc.subject | Health Personnel | en_US |
| dc.subject | Pharmacists | en_US |
| dc.title | Comparative Effectiveness of Pharmacological Interventions to Prevent Smoking Relapse in Recent Quitters: A Systematic Review with Network Meta-Analysis | en_US |
| dc.type | Thesis | |
| dspace.entity.type | Publication |