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Publication - Professor Marcus Munafo

    Use of varenicline and nicotine replacement therapy in people with and without general practitioner-recorded dementia

    retrospective cohort study of routine electronic medical records.

    Citation

    Itani, T, Martin, R, Rai, D, Jones, T, Taylor, G, Thomas, K, Munafo, M, Davies, N & Taylor, A, 2019, ‘Use of varenicline and nicotine replacement therapy in people with and without general practitioner-recorded dementia: retrospective cohort study of routine electronic medical records.’. BMJ Open, vol 9.

    Abstract

    Objectives: Our primary objective was to estimate smoking prevalence and prescribing rates of varenicline and NRT in people with and without GP-recorded dementia. Our secondary objective was to assess and compare quit rates of smokers with versus without general practitioner (GP)-recorded dementia who were prescribed varenicline or nicotine replacement therapy (NRT) for smoking cessation.

    Design: A retrospective cohort study based on the analysis of electronic medical records within the Clinical Practice Research Datalink (2007-2015).

    Setting: 683 general practices in England.

    Participants: People with and without GP-recorded dementia, aged 18 years and have a code indicating that they are a current smoker.

    Intervention: Index prescription of varenicline or NRT (from 1st September 2006).

    Outcome measures: The primary outcomes were smoking prevalence and prescribing rates of varenicline and NRT (2007-2015). The secondary outcome was smoking cessation at 2 years.

    Results: Age and sex-standardised prevalence of smoking was slightly higher in people with GP-recorded dementia than in those without. There were 235,314 people aged 18 years and above prescribed NRT or varenicline. Amongst smokers with GP-recorded dementia (N=447), 409 were prescribed NRT and 38 varenicline. Smokers with GP-recorded dementia were 74% less likely (95% confidence interval: 64% to 82%) to be prescribed varenicline than NRT, compared to smokers without GP-recorded dementia. Compared to people without GP-recorded dementia, people with GP-recorded dementia had consistently lower prescribing rates of varenicline from 2007 to 2015.
    Two years after prescription, there was no clear evidence for a difference in the likelihood of smoking cessation after prescription of these medications between individuals with and without dementia (OR 1.0, 95% CI: 0.8, 1.2).

    Full details in the University publications repository