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February 20, 2018AddictionOpen Access

The effects of prescribing varenicline on two‐year health outcomes: an observational cohort study using electronic medical records

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Why the study?

Does varenicline reduce mortality and serious ill-health compared to nicotine replacement therapy in smokers seeking cessation?

Population

126,718 patients aged 18 and over who were issued smoking cessation prescriptions between 1 September 2006…

Comparison

Varenicline prescription vs Nicotine replacement therapy (NRT) prescription

Design

Cohort

Follow-up

2 years

Authors

NDNeil M DaviesGTGemma TaylorATAmy E. Taylor

Discussion

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Overview

Little evidence of reduced serious ill-health with varenicline versus NRT; leaves open long-term real-world benefits and safety.

Structured PICO

Does varenicline reduce mortality and serious ill-health compared to nicotine replacement therapy in smokers seeking cessation?

P
Population
126,718 patients aged 18 and over who were issued smoking cessation prescriptions between 1 September 2006 and 31 March 2014 in 370 UK general practices.
I
Intervention
Varenicline prescription
C
Comparator
Nicotine replacement therapy (NRT) prescription
O
Outcome
All-cause mortality within 2 years of first prescriptionhard clinical

Varenicline does not appear to reduce the risk of mortality, hospitalization, or myocardial infarction over 2 years compared to nicotine replacement therapy in smokers.

Limitations

  • Potential for residual confounding as people prescribed varenicline were healthier at baseline

Cite This Study

Davies et al. (2018) studied this question.

synapsesocial.com/papers/6a72b6038031ec7bb1dd7401https://doi.org/10.1111/add.14146
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Mortality Risk Reduction Associated With Smoking Cessation in Patients With Coronary Heart Disease2003 · 1,102 citations
  2. 2Validation and validity of diagnoses in the General Practice Research Database: a systematic review2009 · 1,123 citations
  3. 3Risk of cardiovascular serious adverse events associated with varenicline use for tobacco cessation: systematic review and meta-analysis2012 · 206 citations
  4. 4What are the effects of varenicline compared with nicotine replacement therapy on long-term smoking cessation and clinically important outcomes? Protocol for a prospective cohort study2015 · 11 citations
  5. 5Toward a Clearer Portrayal of Confounding Bias in Instrumental Variable Applications2015 · 78 citations