Chronic obstructive pulmonary disease in severe mental illness: A timely diagnosis to advance the process of quitting smoking
Metadatos
Afficher la notice complèteEditorial
Cambridge University Press
Materia
Bipolar disorder COPD Early detection Schizophrenia Smoking
Date
2021-02-26Referencia bibliográfica
Jaen-Moreno MJ, Feu N, del Pozo GI, Gómez C, Carrión L, Chauca GM, Guler I, Montiel FJ, Sánchez MD, Alcalá JA, Gutierrez-Rojas L, Molina V, Bobes J, Balanzá-Martínez V, Ruiz-Rull C, Sarramea F (2021). Chronic obstructive pulmonary disease in severe mental illness: A timely diagnosis to advance the process of quitting smoking. European Psychiatry, 64(1), e22, 1–11 [https://doi.org/10.1192/j.eurpsy.2021.12]
Patrocinador
Spanish Ministry of Economy, Industry, and Competitiveness, Instituto Carlos III FIS PI16/00802Résumé
Background. This study has two main objectives: to describe the prevalence of undetected
chronic obstructive pulmonary disease (COPD) in a clinical sample of smokers with severe
mental illness (SMI), and to assess the value of the Tobacco Intensive Motivational Estimated
Risk tool, which informs smokers of their respiratory risk and uses brief text messages to
reinforce intervention.
Method. A multicenter, randomized, open-label, and active-controlled clinical trial, with a
12-month follow-up. Outpatients with schizophrenia (SZ) and bipolar disorder were randomized
either to the experimental group—studied by spirometry and informed of their calculated
lung age and degree of obstruction (if any)—or to the active control group, who followed the
5 A’s intervention.
Results. The study sample consisted of 160 patients (71.9% SZ), 78.1% of whom completed the
12-month follow-up. Of the patients who completed the spirometry test, 23.9% showed evidence
of COPD (77.8% in moderate or severe stages). TIMER was associated with a significant
reduction in tobacco use at week 12 and in the long term, 21.9% of patients reduced consumption
and 14.6% at least halved it. At week 48, six patients (7.3%) allocated to the experimental group
achieved the seven-day smoking abstinence confirmed by CO (primary outcome in terms of
efficacy), compared to three (3.8%) in the control group.
Conclusion. In this clinical pilot trial, one in four outpatients with an SMI who smoked had
undiagnosed COPD. An intensive intervention tool favors the early detection of COPD and
maintains its efficacy to quit smoking, compared with the standard 5 A’s intervention.