BUPROPION, SMOKING CESSATION, AND HEALTH-RELATED QUALITY OF LIFE FOLLOWING AN ACUTE MYOCARDIAL INFARCTION

Main Article Content

David Dong Qi Zhang
Mark J. Eisenberg
Sonia M. Grandi
Lawrence Joseph
Jennifer O'Laughlin
Gilles Paradis
Pedro Lozano
Kristian B. Filion

Keywords

Smoking cessation, myocardial infarction, bupropion, health - related quality of life

Abstract

Background


The use of bupropion, a smoking cessation aid, has been associated with improved health-related quality of life (HRQOL) in the general population of smokers; but, its effect on HRQOL in post-myocardial infarction (MI) patients remains unknown.


Objectives


To examine the effect of bupropion on HRQOL in post- MI patients who are attempting to quit smoking.


Methods


To accomplish this objective, we used data from a randomized, double-blind, placebo-controlled trial in 392 hospitalized post - MI patients. Treatment duration was 9 weeks, and follow - up was 12 months. HRQOL was assessed via the EuroQol - 5D (EQ - 5D) questionnaire, which includes 5 dimensions (mobility, self - care, daily activities, pain/discomfort, and anxiety/depression). Analyses were restricted to patients (n=225) who completed the EQ - 5D at baseline, 6 months, and 12 months.


Results


Patients randomized to bupropion (n=109) and those randomized to placebo (n=116) experienced similar improvements in HRQOL during follow - up (difference in change in EQ - 5D index from baseline to 6 months = 0.02, 95% confidence interval [CI] = - 0.04, 0.08; from baseline to 12 months = 0.02, 95% CI = - 0.04, 0.08). No between-group differences were observed in any of the 5 dimensions. Similar improvements in HRQOL were observed between patients who remained abstinent and those who relapsed. Lower baseline HRQOL, defined as having a HRQOL that was less than the median value, was associated with decreased smoking abstinence at 12 months follow - up (odds ratio [OR] =0.39, 95% CI = 0.22, 0.68).


Conclusions


Bupropion does not improve HRQOL among patients attempting to quit smoking post - MI.

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References

1. Jorenby DE, Leischow SJ, Nides MA, et al. A controlled trial of sustained-release bupropion, a nicotine patch, or both for smoking cessation. N Engl J Med 1999 March 4;340(9):685 - 91.
2. Hughes JR, Goldstein MG, Hurt RD, Shiffman S. Recent advances in the pharmacotherapy of smoking. JAMA 1999 January 6;281(1):72 - 6.
3. Guyatt GH, Feeny DH, Patrick DL. Measuring health-related quality of life. Ann Intern Med 1993 April 15;118(8):622 - 9.
4. Dunner DL, Kwong WJ, Houser TL, et al. Improved health - related quality of life and reduced productivity loss after treatment with bupropions ustained release: A study in patients with major depression. Prim Care Companion J Clin Psychiatry 2001 February;3(1):10 - 6.
5. Fortner MR, Brown K, Varia IM, et al. Effect of Bupropion SR on the quality of life of elderly depressed patients with comorbid medical disorders. Prim Care Companion J Clin Psychiatry 1999 December;1(6):174 - 9.
6. Hewett K, Chrzanowski W, Jokinen R, et al. Double-blind, placebo-controlled evaluation of extended-release bupropion in elderly patients with major depressive disorder. J Psychopharmacol 2010 April;24(4):521 - 9.
7. Cullum JL, Wojciechowski AE, Pelletier G, Simpson JS. Bupropion sustained release treatment reduces fatigue in cancer patients. Can J Psychiatry 2004 February;49(2):139 - 44.
8. Moss EL, Simpson JS, Pelletier G, Forsyth P. An open-label study of the effects of bupropion SR on fatigue, depression and quality of life of mixed - site cancer patients and their partners. Psychooncology 2006 March;15(3):259 - 67.
9. Hays JT, Croghan IT, Baker CL, Cappelleri JC, Bushmakin AG. Changes in health-related quality of life with smoking cessation treatment. Eur J Public Health 2012 April;22(2):224 - 9.
10. Eisenberg MJ, Grandi SM, Gervais A, et al. Bupropion for smoking cessation in patients hospitalized with acute myocardial infarction: a randomized, placebo-controlled trial. J Am Coll Cardiol 2013 February 5;61 (5):524 - 32.
11. EuroQol -- A new facility for the measurement of health-related quality of life. The EuroQol Group. Health Policy 1990 December;16(3):199 - 208.
12. Shaw JW, Johnson JA, Coons SJ. US valuation of the EQ - 5D health states: development and testing of the D1 valuation model. Med Care 2005 March;43(3):203 - 20.
13. Schweikert B, Hahmann H, Leidl R. Validation of the EuroQol questionnaire in cardiac rehabilitation. Heart 2006 January;92(1):62 - 7.
14. Ellis JJ, Eagle KA, Kline - Rogers EM, Erickson SR. Validation of the EQ - 5D in patients with a history of acute coronary syndrome. Curr Med Res Opin 2005 August;21(8):1209 - 16.
15. Kahyaoglu SH, Unsar S. Is EQ - 5D a valid quality of life instrument in patients with acute coronary syndrome? Anadolu Kardiyol Derg 2011 March;11(2):156 - 62.
16. Beck AT, Steer RA, Brown GK. Manual for the Beck Depression Inventory-II. San Antonio, TX: Psychological Corporation; 1996.
17. Heatherton TF, Kozlowski LT, Frecker RC, Fagerstrom KO. The Fagerstrom Test for Nicotine Dependence: a revision of the Fagerstrom Tolerance Questionnaire. Br J Addict 1991 September;86(9):1119 - 27.
18. Rieckmann N, Kronish IM, Shapiro PA, Whang W, Davidson KW. Serotonin reuptake inhibitor use, depression, and long - term outcomes after an acute coronary syndrome: a prospective cohort study. JAMA Intern Med 2013 June 24;173(12):1150 - 1.
19. Mulder I, Tijhuis M, Smit HA, Kromhout D. Smoking cessation and quality of life: the effect of amount of smoking and time since quitting. Prev Med 2001 December;33(6):653 - 60.
20. McClave AK, Dube SR, Strine TW, et al. Associations between smoking cessation and anxiety and depression among U.S. adults. Addict Behav 2009 June;34(6 - 7):491 - 7.
21. Wilson D, Parsons J, Wakefield M. The health-related quality - of - life of never smokers, ex-smokers, and light, moderate, and heavy smokers. Prev Med 1999 September;29(3):139 - 44.
22. Strine TW, Okoro CA, Chapman DP, et al. Health-related quality of life and health risk behaviors among smokers. Am J Prev Med 2005 February;28(2):182 - 7.
23. Sarna L, Bialous SA, Cooley ME, Jun HJ, Feskanich D. Impact of smoking and smoking cessation on health-related quality of life in women in the Nurses' Health Study. Qual Life Res 2008 December;17(10):1217 - 27.
24. Tillmann M, Silcock J. A comparison of smokers' and ex-smokers' health-related quality of life. J Public Health Med 1997 September;19(3):268 - 73.
25. Wiggers LC, Oort FJ, Peters RJ, Legemate DA, de Haes HC, Smets EM. Smoking cessation may not improve quality of life in atherosclerotic patients. Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco 2006 August;8(4):581 - 9.
26. Quist - Paulsen P, Bakke PS, Gallefoss F. Does smoking cessation improve quality of life in patients with coronary heart disease? Scand Cardiovasc J 2006 February;40(1):11 - 6.
27. Taira DA, Seto TB, Ho KK, et al. Impact of smoking on health-related quality of life after percutaneous coronary revascularization. Circulation 2000 September 19;102(12):1369 - 74.
28. Rumsfeld JS, Ho PM, Magid DJ, et al. Predictors of health-related quality of life after coronary artery bypass surgery. Ann Thorac Surg 2004 May;77(5):1508 - 13.

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