Randomized clinical trial to determine the effectiveness of CO-oximetry and anti-smoking brief advice in a cohort of kidney transplant patients who smoke

• Published in: International journal of medical sciences Vol. 17; no. 17; pp. 2673 - 2684
• Main Authors: Seijo-Bestilleiro, Rocio, Seoane-Pillado, Teresa, Pertega-Diaz, Sonia, González-Martín, Cristina, Valdes-Cañedo, Francisco, Balboa-Barreiro, Vanesa, Fernandez-Rivera, Constantino, Alonso-Hernandez, Angel, Cao-Vilariño, Mercedes, Gil-Guillen, Vicente, Garcia-Rodriguez, Mª Teresa
• Format: Journal Article
• Language: English
• Published: Australia Ivyspring International Publisher Pty Ltd 01.01.2020; Ivyspring International Publisher
• Subjects: Adult; Carbon monoxide; Carbon Monoxide - analysis; Cardiovascular disease; Clinical trials; Cotinine - urine; Diabetes; Female; Follow-Up Studies; Graft Rejection - etiology; Graft Rejection - prevention & control; Humans; Intervention; Kidney diseases; Kidney Transplantation - adverse effects; Kidney transplants; Male; Middle Aged; Mortality; Motivation; Nephrology; Nicotine; Oximetry - methods; Patient Education as Topic - methods; Patients; Research Paper; Self Report - statistics & numerical data; Smoking - adverse effects; Smoking - epidemiology; Smoking - urine; Smoking cessation; Smoking Cessation - methods; Tobacco; Treatment Outcome; Smoking cessation; Carbon monoxide; Controlled clinical trial; Kidney transplantation; Nicotine dependence
• ISSN: 1449-1907; 1449-1907
• DOI: 10.7150/ijms.49401

: measure the efficacy of exhaled carbon monoxide (CO) measurement plus brief advisory sessions to reduce smoking exposure and smoking behaviour in kidney transplant recipients. : Randomized, controlled, open-label clinical trial at a Spanish hospital.Smoking kidney transplant recipients giving their consent to participate were randomized to control (brief advice, n=63) or intervention group (brief advisory session plus measuring exhaled CO, n=59). Measurements: Sociodemographic characteristics, cardiovascular risk factors, treatment, rejection episodes, infections, self-reported smoking, drug use, level of dependence and motivation to stop smoking (Fagerström's and Richmond's test) and stage of change (Prochaska and DiClemente's Stages). Efficacy was assessed at 3, 6, 9 and 12 months as: cotinine test, CO levels in exhaled air, nicotine dependence, motivational stages of change, motivation to stop smoking, pattern of tobacco use and smoking cessation rates. Logistic regression models were computed. : At 12 months of follow-up, differences were found in exhaled CO between the intervention and control group(6.1±6.8vs.10.2±9.7ppm;p=0.028). Carboxyhemoglobin levels were lower in the intervention group as well as the positive cotinine test (1.2±1.2%vs.2.0±2.4%;p=0.039),(53.4%vs.74.2%). At 12 months, intervention reduces the probability of a positive urine test by 28%. : Co-oximetry is a clinically relevant intervention for reduction of tobacco exposure in kidney transplant recipients.