[Manejo de la cesación tabáquica entre residentes de cardiología de Iberoamérica]

Abstract

Introduction and objectives: Although cardiologists frequently assist patients who suffer damage from smoking, the degree of training they receive to manage this problem during their residency is unknown. Because of this, we’d proposed to ­evaluate the preferences and practices of cardiology residents for smoking cessation of the attending patients.

Materials and methods: Closed, prefixed, voluntary and anonymous survey among doctors who carried out the specialty of cardiology in 5 countries of Latin America and Spain.

Results: 716 residents were surveyed; 62.4% from Argentina, 19% from Mexico, 6.8% from Spain, 6.7% from Chile, 3.2% from Uruguay, and 1.9% from Paraguay. When asked about the importance they assigned to this problem (using a scale of 1-10), 85.8% assigned this question a score of 8 or higher. While 80.5% of the participants expressed giving short anti-tobacco advice routinely, only 27.7% used pharmacological therapy for this purpose. Among those who did not use pharmacological therapy, 58.3% said that the reason was not being familiar with the treatments; 62.9% of the surveyed said they had not received any type of training in this problem. Those residents who received some type of training reported feeling more prepared for this (p < 0.0001).

Conclusion: We found that cardiology residents have a low knowledge of pharmacological treatment and relatively low confidence to provide assistance in smoking cessation. This topic should be included in the training of future cardiologists in order to achieve a more comprehensive cardiovascular prevention.

Keywords: Smoking cessation; Nicotine; Varenicline; Bupropion; Training; Residents; Cardiology.

Figura 1

Adicción al tabaco según país de residencia. Se aprecia una tendencia no significativa hacia diferencias en el grado de adicción al tabaco de acuerdo con el país de residencia (p = 0.07).

Figura 2

Autorreporte del grado de preparación para asistir a pacientes fumadores a que abandonen su adicción, según país de residencia. Se observa la diferencia de las medianas de puntuación de los residentes de acuerdo con el país de residencia (p = 0.03). Argentina 5 (RIC 4-7); Uruguay 5 (RIC 3-5); Chile 5.5 (RIC 4-7); México 6 (RIC 5-7); Paraguay 5 (RIC 5-6); España 5 (RIC 3-7). RIC: rango intercuartiles.

Figura 3

Valoración de los participantes según país de residencia, respecto a la relevancia, prioridad, grado de formación y seguridad para la atención de pacientes con adicción al tabaquismo. Expresado en porcentaje de participantes que valoraron estos ítems con 8 o más puntos. La mayoría de los residentes consideró la cesación tabáquica un tema relevante y prioritario en la atención de pacientes fumadores hospitalizados. Si bien se aprecian diferencias en el autorreporte del grado de formación sobre la temática, un bajo porcentaje de residentes de todos los países expresó sentirse muy preparados para esto.