[The prevalence of strategies for cessation of tobacco use in primary health care: an integrative review]

Alcohol abuse in older adults with type 2 diabetes mellitus in primary health care: a cross-sectional study

This cross-sectional study aimed to analyze alcohol abuse in older adults with type 2 diabetes mellitus in primary health care. Household data were collected from March to October 2018 in the Family Health Strategy in Ribeirão Preto, São Paulo through face-to-face interviews with a form application. The pattern of alcohol consumption was estimated with the Alcohol Use Disorders Identification Test-C. A total of 338 older adults with type 2 diabetes mellitus participated, and 19.2% (95%CI 15.0-23.4) engaged in alcohol abuse. Among them, we observed a higher frequency of males (63.1%), aged 60 to 64 years (35.4%), economic class C (49.2%), 1-4 schooling years (53.8%), and multimorbidity (92.3%). There was a negative association between alcohol abuse and drug therapy adherence (PR = 0.55; 95%CI 0.36-0.86). The frequency of alcohol abuse and non-adherence to drug treatment among those with a high consumption pattern is troubling since it can lead to diabetes complications. Therefore, we underscore the importance of multidimensional elderly care and health education in primary care.

Análise retrospectiva de um programa para cessação do tabagismo em município do leste mineiro

Introdução: O programa “Deixando de Fumar sem Mistérios” foi desenvolvido para ajudar os participantes a cessar o tabagismo. Objetivo: Avaliar o número de participantes que cessaram o tabagismo após 12 meses do programa “Deixando de Fumar sem Mistérios”, mensurar o nível atual de dependência da nicotina dos que não cessaram o hábito e detectar os fatores envolvidos na falta de adesão ao programa. Metodologia: Entrevista foi realizada com 39 participantes do programa “Deixando de Fumar sem Mistérios” em um município mineiro, para a aplicação do teste de Fagerström e de questionário sobre o funcionamento do programa. A análise dos dados foi realizada por meio do cálculo das frequências absolutas (n) e relativas (%). Resultados: Dos entrevistados, 23% relataram ter parado de fumar, 51% não faltaram às reuniões, e 74% declararam satisfação com o resultado do programa. O nível de dependência do tabaco dos participantes que não cessaram o tabagismo foi moderado (5,2±2,8 pontos), com consumo médio de 22,9±17,3 cigarros/dia e 35,0±15,5 anos de consumo. Os fatores que mais contribuíram para a falta de adesão foram questões logísticas (56%) e crenças pessoais (36%). Conclusão: O grau de satisfação com o programa foi elevado. A desatualização cadastral dificultou o contato com grande parte dos participantes, evidenciando a necessidade de adaptações logísticas para que o programa contribua mais efetivamente com a cessação do tabagismo dos participantes.

Effectiveness of motivational interviewing in smoking groups in primary healthcare: a community-based randomized cluster trial

Smoking is the main cause of avoidable death and a major public health problem worldwide, with primary healthcare being a strategic setting for treating this problem. Aims: to evaluate the effectiveness of motivational interviewing associated with the cognitive behavioral therapy (CBT) in smoking groups in primary healthcare. A community-based cluster randomized clinical trial was conducted in Brazil, starting in July 2016. Professionals in the test group were trained in motivational interviewing for eight hours to associate it with the CBT. The usual treatment for smoking cessation in groups consists of four structured weekly sessions of 90 minutes each using a CBT. Taylor's linearization was used to correct the p-values; the chi-square test with Pearson correlation was used for categorical variables, and analysis of variance as well as the Student t-test were used for continuous variables. In total, 44 smoking groups were conducted, totaling 329 patients (178 in the motivational interviewing group and 151 in the control group). The smoking cessation rate with motivational interviewing was 61.8%, with RR = 1.25 (95%CI: 1.01-1.54, p = 0.043), and 47.7% in the control group, in the fourth weekly group treatment session. Mean session attendance was 3.1 (95%CI: 2.9-3.3) in the motivational interviewing group and 2.9 (95%CI: 2.5-3.4) in the control group. The completion rate for the motivational interviewing group was 65.2% and for the control group, 57.6%. Motivational interviewing associated with the CBT was shown to be effective and superior to only CBT to smoking cessation in groups in the fourth weekly session and for the population profile of the study (women with an average age of 50.6 years).