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Biomedical subjects

M K Keintz

Publications and source records attributed to M K Keintz.

At least 19 recordsLinked to original sources
PubMed1994

Use of transdermal nicotine in a state-level prescription plan for the elderly. A first look at 'real-world' patch users.

OBJECTIVE: To assess transdermal nicotine use patterns and outcomes in a population of low-income older smokers. DESIGN: A 6-month telephone follow-up survey of smokers filling prescriptions for transdermal nicotine in the first 3 months of 1992. SETTING: Pennsylvania's Pharmaceutical Assistance Plan for the Elderly, the nation's largest state-level prescription plan for the elderly. POPULATION: A total of 1070 noninstitutionalized male and female smokers aged 65 through 74 years. MAIN OUTCOME MEASURES: Self-reported physician/pharmacist advice and adjunctive treatments, concomitant smoking, and 6-month smoking abstinence. RESULTS: Respondents were predominantly long-term heavy smokers. They used nicotine patches for an average of 5 weeks, with few reporting use beyond 3 months or recalling bothersome side effects. Most of those with previous quit attempts rated quitting with the patch "easier." The 29% self-reported 6-month quit rate observed is encouraging. However, compliance with patch use guidelines was far from ideal in this high-risk population: only 54% of respondents received any initial advice or materials from their physicians or pharmacists, fewer than 2% took part in a formal clinic or one-to-one treatment program, and almost half (47%) smoked while using the patch, including 20% who smoked every day. Concomitant smoking was strongly associated with failure to achieve abstinence (P < .001). More frequent contact with physicians and/or pharmacists was associated with less concomitant smoking (P < .001) and higher quit rates (P = .005). CONCLUSIONS: This survey offers an important first look at problems and prospects for nicotine patch therapy in older adults, with implications for other groups as well. Prospective studies are needed to clarify optimal treatment regimens and adjuncts.

Administration, Cutaneous↗
PubMed1994

Reaching mothers of preschool-aged children with a targeted quit smoking intervention.

Younger women smoke at disproportionately higher rates than other women and their smoking has a major impact on the health of their young children. To address this problem, a smoking cessation intervention combining minimal advice and assistance from a community health nurse and a tailored self-help guide was developed for low-income women with young children. The program evaluation results reported here were gathered from women using publicly funded pediatric services in four agencies with 32 clinic sites in central and eastern Pennsylvania. Unlike volunteers in formal cessation programs, the women varied widely in their readiness to quit smoking. Follow-up data were obtained from 1,230 female smokers, aged 18 to 39, after receiving brief, individualized smoking cessation advice and encouragement to read the self-help guide. One year later, 12.5 percent reported quitting smoking, and 20.2 percent reported having made a serious quit attempt that lasted at least 7 days. These results suggest that, even among smokers with low socioeconomic status and wide variation in their readiness to quit, minimal intervention programs requiring modest resources can promote cessation.

Adult↗
PubMed1994

Does tailoring matter? The impact of a tailored guide on ratings and short-term smoking-related outcomes for older smokers.

There is new evidence that smokers of all ages benefit from cessation of smoking. Although most older smokers, like younger smokers, prefer to quit on their own, at the time this project was started, there were no materials or programs targeted to older smokers. Using the literature, focus groups with older smokers and a national survey of older smokers, we created Clear Horizons, a self-help guide for older smokers, and a telephone counseling protocol tailored to the needs of older smokers (age 50-74). Smokers were recruited from around the United States and assigned randomly to a control guide, Clearing the Air, Clear Horizons alone or Clear Horizons and two counselor calls. Follow-up of nearly 2000 smokers was conducted by telephone 3, 6, 12 and 24 months after delivery of the self-help guides. This report focuses primarily on results at 3 months because that was the measurement for reactions to the interventions. At the 3 month interview, those in the tailored interventions rated their guides more highly than did those in the control group. They also read more of their guides and were more likely to reread them. Quit rates were significantly higher among smokers who received a combination of the tailored guide and telephone counseling. At 3 months, the combination of the guide and telephone counseling was most effective in helping smokers to quit. By 12 months, both the tailored guide alone and the tailored guide and calls groups had higher quit rates than the control guide but were not statistically different from one another.

Age Factors↗
PubMed1991

A national survey of older smokers: treatment needs of a growing population.

Examined smoking and quitting patterns among 289 smokers ages 50 to 74 years who took part in a nationwide survey of American Association of Retired Persons members. Respondents were predominantly chronic, heavy smokers. They had smoked for an average of 45 years, more than one third smoked 25 or more cigarettes per day, and more than two thirds showed evidence of high nicotine addiction. Nonetheless, most were interested in quitting smoking and reported plans to quit in the next year. Concerns about missing or craving cigarettes; losing a pleasure; and being nervous, tense, or irritable after quitting were the most common barriers to quitting reported. These problems were rated as more serious by heavier, longer term smokers and by smokers with lower quitting self-efficacy. The variables most strongly associated with "contemplating" quitting were beliefs in quitting health benefits, recent attempts to quit or cut down, prior attempts to quit, and high self-efficacy. Limitations of these findings are discussed along with implications for the design of treatments geared to the special needs of older smokers.

Aged↗
PubMed1990

The older smoker. Status, challenges and opportunities for intervention.

Smoking is a significant cause of morbidity and mortality among older adults. Cessation of smoking benefits older adults almost immediately. Little is known, however, about how older adults quit and how to help them. No smoking cessation programs have been designed for this population. Here we report the findings of a random survey of American Association of Retired Persons members conducted to learn more about older smokers, their smoking and health characteristics, their quitting motivations and experiences, and the role of physicians' advice to quit. We obtained data on 339 current smokers aged 50 to 102. Current smokers were more likely to be heavy, highly addicted smokers. They also reported more smoking-related symptoms and conditions and fewer preventive tests and check-ups than never-smokers or former smokers. Although 44 percent of smokers were interested in quitting, only 39 percent reported that they had been advised to stop smoking by their physicians in the previous year. Physicians who treat older patients can have a significant impact on helping them to stop smoking by giving them a strong recommendation to quit and by providing appropriate interventions.

Aged↗
PubMed1989

Why women resist screening mammography: patient-related barriers.

Mammography utilization remains below the level needed to achieve the National Cancer Institute's year-2000 goals for reducing breast cancer mortality by 50%. Previous research has identified both patient and physician barriers. The authors interviewed 600 randomly selected women who were offered a free mammographic examination. Interviews were conducted by professional interviewers using a brief, structured questionnaire. Data were analyzed with chi 2 Wilcoxon and Kruskal-Wallis rank-sum statistics and discriminant analysis. Noncompliant subjects reported more barriers than compliant subjects. The former were more likely to believe that mammography is unnecessary in the absence of symptoms and that it is inconvenient. In both the bivariate and multivariate analyses, the woman's belief that her doctor believes in regular mammography was an important predictor of compliance.

Adult↗
PubMed1987

Enhancing cancer pain control regimens through patient education.

The problem of cancer-related pain afflicts millions of people annually. The study described here was aimed at improving cancer patients' pain control through a planned patient education program. A randomized clinical trial with a Solomon Four-Group design was used to assess the effectiveness of a patient education intervention consisting of nurse counseling and printed materials. The sample included 230 cancer patients. One month later, patients in the experimental group were more likely to have taken their pain medicine on the correct schedule and to have taken the correct dosage. The experimental group also was significantly less likely to report stopping the medicine when they felt better. In addition, they were significantly less worried about tolerance and addiction to pain medicines. Forty-four percent of the experimental group compared to 24% of the control group reported no or mild pain at the posttest.

Aged↗
PubMed1987

Improving cancer patients' pain control through education.

While patient accrual for this study is not yet complete, it appears that the intervention may be helping patients to feel more in control over their pain, take the correct medication dosage and take action to prevent side effects. At this point, the experimental subjects seem much less worried about tolerance to pain medications. The early results suggest some sociodemographic differences in response to pain which, if they persist, should probably be considered as factors in designing patient education programs.

Analgesics, Opioid↗
PubMed1986

A survey of physicians' views and practices on patient education for smoking cessation.

A two-wave panel survey of physicians in southeastern Pennsylvania assessed the smoking intervention strategies physicians use with their patients, their intention to prescribe nicotine chewing gum (Nicorette), and their subsequent prescribing of Nicorette. The most frequently employed health education strategies were counseling, counseling in combination with written materials or referral, and recommendation to stop smoking, with significant differences among specialty groups. Most of the responding physicians (87%) were aware of nicotine chewing gum; of those aware, 71% reported an intention to prescribe it for their patients who smoke. Physicians' prescription patterns differed by specialty: family practitioners were most inclined to prescribe Nicorette. Forty-seven percent of physicians had no follow-up data on the patients for whom they had prescribed Nicorette. The survey data reported here demonstrate that physicians are willing to adopt a new smoking cessation practice. The challenge is to incorporate this practice into a cost-effective smoking cessation intervention which can be integrated into the routine of patient care.

Chewing Gum↗
PubMed1985

Cancer patient education: reality and potential.

Cancer now attacks one in three Americans, resulting in one in six deaths. Yet, until recently, few patient education programs were directed toward cancer patients. This review examines the status of cancer patient education and suggests future directions. We focus on several aspects of cancer patient education, including needs assessments and programs in treatment, rehabilitation, and continuing care and evaluation. The most comprehensive patient education programs are those directed toward patients in active treatment; one of its tasks is to help patients manage treatment side effects. A major component of rehabilitation programs is counseling patients to help them cope with the effects of cancer. Many patient education programs have performed evaluations; most reflect difficulties in one or more areas, such as selecting appropriate measures or accruing adequate sample sizes. We recommend several directions for the future, including the use of appropriate measurement tools, adequate sample sizes, multimodality programs with incorporation of psychological techniques such as relaxation training and guided imagery, and assessment of the impact of patient education programs on costs.

Counseling↗