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Factors associated with smoking and smoking cessation among primary care patients with depression: a naturalistic cohort study
- Authors:
- GILCHRIST Gail, et al
- Journal article citation:
- Advances in Dual Diagnosis, 8(1), 2015, pp.18-28.
- Publisher:
- Emerald
Purpose: People with a history of depression are more likely to smoke and less likely to achieve abstinence from smoking long term. The purpose of this paper is to understand the factors associated with smoking and smoking cessation among patients with depression. Design/methodology/approach: This paper reports on smoking prevalence and cessation in a cohort of 789 primary care attendees with depressive symptoms (Centre for Epidemiologic Studies Depression Scale score of=16) recruited from 30 randomly selected Primary Care Practices in Victoria, Australia in 2005. Findings: At baseline, 32 per cent of participants smoked. Smokers were more likely to be male, unmarried, receive government benefits, have difficulty managing on available income, have emphysema, a chronic illness, poor self-rated health, to have more severe depressive and anxiety symptoms, to be taking anti-depressants, to be hazardous drinkers, to report suicidal ideation and to have experienced childhood physical or sexual abuse. At 12 months, 20 participants reported quitting. Females and people with good or better self-rated health were significantly more likely to have quit, while people with a chronic illness or suicidal ideation were less likely to quit. Smoking cessation was not associated with increases in depression or anxiety symptoms. Only six participants remained quit over four years. Practical implications: Rates of smoking were high, and long-term cessation was low among primary care patients with depressive symptoms. Primary care physicians should provide additional monitoring and support to assist smokers with depression quit and remain quit. Originality/value: This is the first naturalistic study of smoking patterns among primary care attendees with depressive symptoms. (Publisher abstract)
Integrating addiction and mental health networks to improve access to treatment for people with alcohol and drug-related problems: a qualitative study
- Authors:
- FONSECA Francina, GILCHRIST Gail, TORRENS Marta
- Journal article citation:
- Advances in Dual Diagnosis, 5(1), 2012, pp.5-14.
- Publisher:
- Emerald
Improvement in Access to Treatment for People with Alcohol and Drug Related Problems (IATPAD) was a European multi-centre study designed to detect barriers and facilitators to accessing treatment for patients with alcohol and drug-related problems. This article reports the main findings of the qualitative study carrier out in Catalunya. A total of 47 staff were interviewed from a randomly selected sample of the three main entry points to treatment for patients with alcohol and drug problems; out-patient general psychiatry centres (CSMA); out-patient addiction centres (CAS); and primary care centres (CAP). Open-ended responses were also collated from 142 additional staff on barriers and facilitators to accessing treatment for patients with alcohol and drug problems and how these barriers could be improved. A total of 25 patients from two CAS were interviewed in-depth. Many opinions about accessing treatment were shared by staff and patients. These included patients' motivation, centres' opening hours, staff attitudes, the provision of information about services, and stigma. In addition staff mentioned referral waiting times and the co-ordination and integration of different services (mainly the mental health and addiction sectors). Patients were also influenced by previous treatment experiences. The authors make recommendations for the improvement of service accessibility for patients with addiction problems and those with a dual diagnosis.