Using PICO Methodology to Answer Questions About Smoking in COPD Patients

array:24 ["pii" => "S1579212917302987" "issn" => "15792129" "doi" => "10.1016/j.arbr.2017.04.018" "estado" => "S300" "fechaPublicacion" => "2017-11-01" "aid" => "1620" "copyright" => "SEPAR" "copyrightAnyo" => "2017" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Arch Bronconeumol. 2017;53:622-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2796 "formatos" => array:3 [ "EPUB" => 167 "HTML" => 1825 "PDF" => 804 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0300289617301333" "issn" => "03002896" "doi" => "10.1016/j.arbres.2017.04.012" "estado" => "S300" "fechaPublicacion" => "2017-11-01" "aid" => "1620" "copyright" => "SEPAR" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Arch Bronconeumol. 2017;53:622-8" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 5760 "formatos" => array:3 [ "EPUB" => 166 "HTML" => 4682 "PDF" => 912 ] ] "es" => array:12 [ "idiomaDefecto" => true "cabecera" => "Artículo especial" "titulo" => "Preguntas y respuestas relacionadas con tabaquismo en pacientes con EPOC. Aplicación de metodología con formato PICO" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "622" "paginaFinal" => "628" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Using PICO Methodology to Answer Questions About Smoking in COPD Patients" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Carlos A. Jiménez Ruiz, Daniel Buljubasich, Juan Antonio Riesco Miranda, Agustín Acuña Izcaray, José Ignacio de Granda Orive, José Miguel Chatkin, Gustavo Zabert, Alfredo Guerreros Benavides, Nelson Paez Espinel, Valeri Noé, Efraín Sánchez-Angarita, Ingrid Núñez-Sánchez, Raúl H. Sansores, Alejandro Casas, Andrés Palomar Lever, Inmaculada Alfageme Michavila" "autores" => array:16 [ 0 => array:2 [ "nombre" => "Carlos A." "apellidos" => "Jiménez Ruiz" ] 1 => array:2 [ "nombre" => "Daniel" "apellidos" => "Buljubasich" ] 2 => array:2 [ "nombre" => "Juan Antonio" "apellidos" => "Riesco Miranda" ] 3 => array:2 [ "nombre" => "Agustín" "apellidos" => "Acuña Izcaray" ] 4 => array:2 [ "nombre" => "José Ignacio" "apellidos" => "de Granda Orive" ] 5 => array:2 [ "nombre" => "José Miguel" "apellidos" => "Chatkin" ] 6 => array:2 [ "nombre" => "Gustavo" "apellidos" => "Zabert" ] 7 => array:2 [ "nombre" => "Alfredo" "apellidos" => "Guerreros Benavides" ] 8 => array:2 [ "nombre" => "Nelson" "apellidos" => "Paez Espinel" ] 9 => array:2 [ "nombre" => "Valeri" "apellidos" => "Noé" ] 10 => array:2 [ "nombre" => "Efraín" "apellidos" => "Sánchez-Angarita" ] 11 => array:2 [ "nombre" => "Ingrid" "apellidos" => "Núñez-Sánchez" ] 12 => array:2 [ "nombre" => "Raúl H." "apellidos" => "Sansores" ] 13 => array:2 [ "nombre" => "Alejandro" "apellidos" => "Casas" ] 14 => array:2 [ "nombre" => "Andrés" "apellidos" => "Palomar Lever" ] 15 => array:2 [ "nombre" => "Inmaculada" "apellidos" => "Alfageme Michavila" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1579212917302987" "doi" => "10.1016/j.arbr.2017.04.018" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212917302987?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289617301333?idApp=UINPBA00003Z" "url" => "/03002896/0000005300000011/v1_201710310034/S0300289617301333/v1_201710310034/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S1579212917303026" "issn" => "15792129" "doi" => "10.1016/j.arbr.2017.09.004" "estado" => "S300" "fechaPublicacion" => "2017-11-01" "aid" => "1631" "copyright" => "SEPAR" "documento" => "article" "crossmark" => 1 "subdocumento" => "ssu" "cita" => "Arch Bronconeumol. 2017;53:629-36" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 6923 "formatos" => array:3 [ "EPUB" => 196 "HTML" => 5590 "PDF" => 1137 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "Review article" "titulo" => "Diagnosis and Management of Pleural Transudates" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "629" "paginaFinal" => "636" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Diagnóstico y manejo de los trasudados pleurales" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 4143 "Ancho" => 2167 "Tamanyo" => 565685 ] ] "descripcion" => array:1 [ "en" => "Schematic representation of the movement of fluid in the pleural space in normal conditions (A), in heart failure (B) and in trapped lung (C). In normal lung and pleura (A), the balance of hydrostatic and oncotic pressures promotes the formation of pleural fluid. Pressure gradients show a net flow of fluid from the parietal pleura and that balance is maintained in the visceral pleura (pressures in cmH2O). In heart failure (B), fluid in the pulmonary interstitium increases due to increased pulmonary capillary pressures. Fluid that enters the pleural space exceeds the drainage capacity of the pleural lymphatic capillaries. In trapped lung (C), a previous inflammatory process has produced a thick, fibrous visceral pleura. The inability of the lung to expand leads to a negative hydrostatic pleural pressure and this alteration of the Starling's forces leads to the formation of pleural transudate. Pleural effusion may be verging on exudate, depending on how recent the active inflammation was." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Lucía Ferreiro, José M. Porcel, Luis Valdés" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Lucía" "apellidos" => "Ferreiro" ] 1 => array:2 [ "nombre" => "José M." "apellidos" => "Porcel" ] 2 => array:2 [ "nombre" => "Luis" "apellidos" => "Valdés" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0300289617301461" "doi" => "10.1016/j.arbres.2017.04.018" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289617301461?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212917303026?idApp=UINPBA00003Z" "url" => "/15792129/0000005300000011/v2_201711201359/S1579212917303026/v2_201711201359/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1579212917303075" "issn" => "15792129" "doi" => "10.1016/j.arbr.2017.09.006" "estado" => "S300" "fechaPublicacion" => "2017-11-01" "aid" => "1600" "copyright" => "SEPAR" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Arch Bronconeumol. 2017;53:616-21" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1376 "formatos" => array:3 [ "EPUB" => 139 "HTML" => 897 "PDF" => 340 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "Original Article" "titulo" => "Relationship Between Chronic Obstructive Pulmonary Disease and Air Pollutants Depending on the Origin and Trajectory of Air Masses in the North of Spain" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "616" "paginaFinal" => "621" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Análisis de la relación entre la enfermedad pulmonar obstructiva crónica y los contaminantes atmosféricos atendiendo al origen y trayectoria de las masas de aire en el Norte de España" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1046 "Ancho" => 1658 "Tamanyo" => 109176 ] ] "descripcion" => array:1 [ "en" => "Back-trajectories: types and origin. AFR: North Africa and Mediterranean region of the peninsula; EU: French Cantabrian region; N: British Isles; NW: north Atlantic; RECIRC: recirculation; SW: Portuguese South-Atlantic." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Ana Santurtún, Domingo F. Rasilla, Leyre Riancho-Zarrabeitia, María T. Zarrabeitia" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Ana" "apellidos" => "Santurtún" ] 1 => array:2 [ "nombre" => "Domingo F." "apellidos" => "Rasilla" ] 2 => array:2 [ "nombre" => "Leyre" "apellidos" => "Riancho-Zarrabeitia" ] 3 => array:2 [ "nombre" => "María T." "apellidos" => "Zarrabeitia" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0300289617300832" "doi" => "10.1016/j.arbres.2017.03.017" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289617300832?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212917303075?idApp=UINPBA00003Z" "url" => "/15792129/0000005300000011/v2_201711201359/S1579212917303075/v2_201711201359/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "Special article" "titulo" => "Using PICO Methodology to Answer Questions About Smoking in COPD Patients" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "622" "paginaFinal" => "628" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Carlos A. Jiménez Ruiz, Daniel Buljubasich, Juan Antonio Riesco Miranda, Agustín Acuña Izcaray, José Ignacio de Granda Orive, José Miguel Chatkin, Gustavo Zabert, Alfredo Guerreros Benavides, Nelson Paez Espinel, Valeri Noé, Efraín Sánchez-Angarita, Ingrid Núñez-Sánchez, Raúl H. Sansores, Alejandro Casas, Andrés Palomar Lever, Inmaculada Alfageme Michavila" "autores" => array:16 [ 0 => array:4 [ "nombre" => "Carlos A." "apellidos" => "Jiménez Ruiz" "email" => array:1 [ 0 => "victorina@ctv.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Daniel" "apellidos" => "Buljubasich" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Juan Antonio" "apellidos" => "Riesco Miranda" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] ] ] 3 => array:3 [ "nombre" => "Agustín" "apellidos" => "Acuña Izcaray" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "d" "identificador" => "aff0020" ] ] ] 4 => array:3 [ "nombre" => "José Ignacio" "apellidos" => "de Granda Orive" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "e" "identificador" => "aff0025" ] ] ] 5 => array:3 [ "nombre" => "José Miguel" "apellidos" => "Chatkin" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "f" "identificador" => "aff0030" ] ] ] 6 => array:3 [ "nombre" => "Gustavo" "apellidos" => "Zabert" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "g" "identificador" => "aff0035" ] ] ] 7 => array:3 [ "nombre" => "Alfredo" "apellidos" => "Guerreros Benavides" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "h" "identificador" => "aff0040" ] ] ] 8 => array:3 [ "nombre" => "Nelson" "apellidos" => "Paez Espinel" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "i" "identificador" => "aff0045" ] ] ] 9 => array:3 [ "nombre" => "Valeri" "apellidos" => "Noé" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "j" "identificador" => "aff0050" ] ] ] 10 => array:3 [ "nombre" => "Efraín" "apellidos" => "Sánchez-Angarita" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "k" "identificador" => "aff0055" ] ] ] 11 => array:3 [ "nombre" => "Ingrid" "apellidos" => "Núñez-Sánchez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "l" "identificador" => "aff0060" ] ] ] 12 => array:3 [ "nombre" => "Raúl H." "apellidos" => "Sansores" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "j" "identificador" => "aff0050" ] ] ] 13 => array:3 [ "nombre" => "Alejandro" "apellidos" => "Casas" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "m" "identificador" => "aff0065" ] ] ] 14 => array:3 [ "nombre" => "Andrés" "apellidos" => "Palomar Lever" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "n" "identificador" => "aff0070" ] ] ] 15 => array:3 [ "nombre" => "Inmaculada" "apellidos" => "Alfageme Michavila" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "o" "identificador" => "aff0075" ] ] ] ] "afiliaciones" => array:15 [ 0 => array:3 [ "entidad" => "Unidad Especializada en Tabaquismo, PII Tabaquismo SEPAR, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Neumología, Hospital Español, Grupo Tabaquismo ALAT Rosario, Argentina" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Neumología, Hospital San Pedro de Alcántara, Cáceres, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Hospital Universitario de Caracas, Universidad Central de Venezuela, Centro Médico Docente La Trinidad, Caracas, Venezuela" "etiqueta" => "d" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Servicio de Neumología, Hospital Universitario 12 de Octubre, Área de Tabaquismo SEPAR, Madrid, Spain" "etiqueta" => "e" "identificador" => "aff0025" ] 5 => array:3 [ "entidad" => "Medicina Interna, Faculdade de Medicina, Pontificia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil" "etiqueta" => "f" "identificador" => "aff0030" ] 6 => array:3 [ "entidad" => "Asociación Latinoamericana del Tórax, Facultad de Ciencias Médicas, Universidad Nacional del Comahue, Neuquén, Argentina" "etiqueta" => "g" "identificador" => "aff0035" ] 7 => array:3 [ "entidad" => "Facultad de Medicina San Fernando, Universidad Nacional Mayor de San Marcos, Sociedad Peruana de Neumología, Lima, Peru" "etiqueta" => "h" "identificador" => "aff0040" ] 8 => array:3 [ "entidad" => "Fundación Neumológica Colombiana, Programa de cesación de Tabaquismo “Exfumaire”, Universidad de La Sabana, Chía, Colombia" "etiqueta" => "i" "identificador" => "aff0045" ] 9 => array:3 [ "entidad" => "Departamento de Investigación en Tabaquismo y EPOC, Instituto Nacional de Enfermedades Respiratorias, Ciudad de México, Mexico" "etiqueta" => "j" "identificador" => "aff0050" ] 10 => array:3 [ "entidad" => "Servicio de Neumología, Hospital Universitario de Caracas, Universidad Central de Venezuela, Centro Médico docente La Trinidad, Caracas, Venezuela" "etiqueta" => "k" "identificador" => "aff0055" ] 11 => array:3 [ "entidad" => "Servicio de Neumología y Cirugía de Tórax, Hospital Universitario de Caracas, Universidad Central de Venezuela, Caracas, Venezuela" "etiqueta" => "l" "identificador" => "aff0060" ] 12 => array:3 [ "entidad" => "Universidad del Rosario, Fundación Neumológica Colombiana, Bogotá, Colombia" "etiqueta" => "m" "identificador" => "aff0065" ] 13 => array:3 [ "entidad" => "Centro médico ABC de la Ciudad de México, Escuela de Medicina del TEC de Monterrey Campus ABC de la Ciudad México, Ciudad de México, Mexico" "etiqueta" => "n" "identificador" => "aff0070" ] 14 => array:3 [ "entidad" => "Hospital Universitario Virgen de Valme, Universidad de Sevilla, SEPAR, Sevilla, Spain" "etiqueta" => "o" "identificador" => "aff0075" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Preguntas y respuestas relacionadas con tabaquismo en pacientes con EPOC. Aplicación de metodología con formato PICO" ] ] "textoCompleto" => "IntroductionApproximately 85% of chronic obstructive pulmonary disease (COPD) is caused by tobacco consumption. Smoking cessation is the only measure that has been shown to be effective for halting the progression of the disease.<a class="elsevierStyleCrossRef" href="#bib0195">1</a> Various papers have analyzed the characteristics of health interventions for smoking cessation in smokers with COPD.<a class="elsevierStyleCrossRefs" href="#bib0200">2–6</a> In all of these, some outstanding questions remain to be answered using scientific methodology.The Treatment and Control of Smoking Groups of the Latin-American Thoracic Association (ALAT) and the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) have collaborated in the preparation of this document which uses PICO methodology to answer questions on smoking cessation treatment in COPD patients. The main objective of this document is to provide healthcare professionals with up-to-date scientific information in this area.MethodologyA collaborative group was formed and clinical questions were formulated. Four working subgroups were constituted, formed of members of the two medical associations involved, ALAT and SEPAR. These subgroups drew up a list of clinical questions and selected by consensus those that should be addressed in these recommendations. In order to focus the search for available evidence, all clinical questions were transformed to the PICO format or the PECO variant: Patient (problem or population), Intervention or Exposure, Comparison, and Outcome.<a class="elsevierStyleCrossRef" href="#bib0225">7</a>The literature search strategy was conducted simultaneously in 2 metasearch engines, the Trip database and PubMed, using MeSH (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>Eligibility CriteriaThe results retrieved for PICO questions were prioritized according to the highest level of evidence (randomized controlled trials [RCTs], meta-analyses and systematic reviews) and the most appropriate answer to the clinical question. If this was not possible, intermediate (observational) or low level (open-label, case series or consensus) studies in the hierarchy of evidence were selected. The recommended algorithmic selection method was used primarily for therapeutic questions.<a class="elsevierStyleCrossRef" href="#bib0230">8</a> Studies published in Spanish, Portuguese and English were considered for inclusion. The end date of the search was May 2016 (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>).<elsevierMultimedia ident="tbl0010"></elsevierMultimedia>Critical Analysis and Formulation of RecommendationsRecommendations and templates developed by the CASPE network (<a href="http://www.redcaspe.org/">www.redcaspe.org</a>) were used for the critical appraisal of the selected references. The ACCP grading system was used to classify recommendations as strong<a class="elsevierStyleCrossRef" href="#bib0195">1</a> or weak,<a class="elsevierStyleCrossRef" href="#bib0200">2</a> according to the balance of risk, benefits, burdens, and, in some cases, cost. The quality of evidence was classified as high (A), moderate (B) or low (C), depending on the study design, consistency of results, and ability of the evidence to clearly answer the PICO question.<a class="elsevierStyleCrossRef" href="#bib0235">9</a>The authors appointed two external reviewers with expertise in the field of COPD and smoking.PICO QuestionDoes spirometry motivate the smoker with COPD to stop smoking?RationaleSignificant efforts have been made to increase the rate of smoking cessation using motivational tools and measures, such as spirometry measurements, co-oximetry, and the calculation of lung age. It is of interest to determine the status of current clinical research aimed at answering this question.Search ResultsThirty-one references were retrieved (MeSH: 5; Trip database: 26), and 7 studies were selected to answer the question (2 systematic reviews, 4 randomized clinical trials [RCT], and 1 cohort study).Quality of EvidenceOne systematic review found limited benefits from the use of spirometry as a motivating factor for increasing smoking cessation,<a class="elsevierStyleCrossRef" href="#bib0240">10</a> and another<a class="elsevierStyleCrossRef" href="#bib0245">11</a> evaluated the effectiveness of the use of biomedical instruments for increasing motivation in smoking cessation. Both included 15 RCTs, 2 of which used spirometry in primary care as a motivator. No statistically significant benefit was identified in the smoking cessation rate when spirometry was used. The analysis does not evaluate the motivating effect of the spirometry test when the result was abnormal. In this respect, a more recent RCT<a class="elsevierStyleCrossRef" href="#bib0250">12</a> showed that bronchial obstruction was the most significant predictor of smoking cessation (OR: 4.215; 95% CI: 2.215–7.865). Similarly, in another study,<a class="elsevierStyleCrossRef" href="#bib0255">13</a> 4494 smokers selected from 100000 subjects with obstructive spirometry were informed in a phone call about COPD and given brief smoking cessation counseling. The results showed a cessation rate of 16.3% among patients with obstruction compared to 12% among those with normal spirometry (P=.0003). An RCT<a class="elsevierStyleCrossRef" href="#bib0260">14</a> which compared COPD patients to smokers with normal spirometry, and included a 3-year follow-up and pharmacological interventions, found a higher rate of cessation among smokers with COPD at the 3-year follow-up (29% versus 14%; P=.003).As for the motivating effect of explaining to the patient their lung age calculated according to spirometry, an RCT<a class="elsevierStyleCrossRef" href="#bib0265">15</a> found a smoking cessation rate at 12 months of 13.6% compared to 6.4% in the control group (P=.05; NNT=14).An RCT<a class="elsevierStyleCrossRef" href="#bib0270">16</a> failed to show efficacy when smokers with no previous diagnosis of COPD were confronted with spirometry results, even though the cessation rate was twice that of the control group (OR: 2.02; 95% CI: 0.63–6.46).Conclusions and RecommendationsModerate evidence that spirometry results encourage smoking cessation in patients with COPD or in at-risk smokers.Strong recommendation to perform spirometry in patients with a diagnosis or in symptomatic smokers as a motivational tool and for diagnostic purposes in active case-finding.Grade of recommendation: 1B.PICO QuestionIs the treatment of smoking different between smokers with and without COPD?RationaleThe conclusions from studies analyzing the treatment of smoking among smokers with COPD suggest that the combination of psychological counseling and pharmacological treatment is most effective.<a class="elsevierStyleCrossRefs" href="#bib0200">2,17–19</a>It seems clear that when the intensity of psychological counseling is mild, efficacy in this group of smokers is very limited or non-existent. In smokers with COPD, psychological counseling should be intense both in terms of number of sessions and time dedicated to each session. Counseling must be offered with empathy, respect and understanding for the patient. The intimate relationship between the consumption of tobacco and COPD should be clearly explained to the patient, and they must be shown that the only treatment that has been identified as capable of controlling the chronic evolution of the disease is to stop smoking. Similarly, it must emphasized that in COPD, giving up smoking contributes definitively to the control of the four major symptoms of COPD: cough, expectoration, dyspnea, and chest tightness.<a class="elsevierStyleCrossRefs" href="#bib0200">2,17–19</a>Three types of drugs have been used in clinical studies: nicotine replacement therapy (NRT), varenicline and bupropion. All these studies have shown that the association between active drug and psychological counseling is more effective than the association between counseling and placebo. NRT and varenicline have been shown to be effective at 6 and 12 months of follow-up, whereas bupropion was effective at 6 months only.<a class="elsevierStyleCrossRefs" href="#bib0200">2,17–19</a>A study has found that the efficacy rates in these patients are higher when pharmacological treatment is offered in addition to counseling (for more than 3 months, or in a combination of several drugs, or at high doses).<a class="elsevierStyleCrossRefs" href="#bib0205">3,4</a>It is important to determine which components are indispensable in the counseling of smokers, in order to make it more effective. It is also important to determine how to provide the most effective pharmacological treatment.Search SelectionThirty-one references were retrieved (MeSH: 5; Trip database: 22), and 8 studies were selected to answer the question (3 systematic reviews, 2 meta-analyses, 2 RCTs, and 1 cross-sectional study).Summary of EvidenceOne of the first reviews on smoking cessation in smokers with COPD showed that the combination of behavioral counseling and pharmacological treatment was superior to no treatment (RR: 4.0; 95% CI: 3.25–4.93) or the use of behavioral counseling only (RR: 4.19; 95% CI: 3.41–5.15).<a class="elsevierStyleCrossRef" href="#bib0275">17</a>Another meta-analysis evaluated 7332 patients with COPD who received different treatments for smoking cessation, and found that the combination of behavioral counseling plus NRT was the most effective type of intervention (OR: 5.08; P<.0001) compared to behavioral counseling only (OR: 2.8; P=.001) and compared to behavioral counseling in combination with an antidepressant (OR: 3.32; P=.002). Behavioral counseling only came close to achieving efficacy when compared with standard care (OR: 1.81; P=.07).<a class="elsevierStyleCrossRef" href="#bib0290">20</a>Another study evaluated the effectiveness of high-intensity smoking treatment in smokers with COPD compared with standard care. The high-intensity program consisted of a combination of pharmacological treatment plus hospitalization for 2 weeks and the administration of intensive behavioral counseling; telephone contacts and continuous monitoring were also programmed for a period of 1–3 years. Abstinence figures in the group that received the intensive treatment were 52% and 38% at 1 and 3 years of follow-up, respectively, vs 7% and 10%, respectively, in the group that received standard care.<a class="elsevierStyleCrossRef" href="#bib0295">21</a>One of studies that has shed most light on the issue is probably that of Hoogendoon et al.,<a class="elsevierStyleCrossRef" href="#bib0280">18</a> who conducted a systematic review of various clinical trials in patients with COPD. The different interventions were grouped into 4 categories: standard care, minimal intervention, intensive behavioral counseling, and intensive behavioral counseling plus pharmacological treatment. The abstinence rates after 1 year of follow-up for each of the categories were: 1.4%, 2.6%, 6% and 12.3%, respectively. Compared to standard treatment, the cost per quality-adjusted life year (QALY) gained for the minimum intervention was 16900 euros, 8200 euros for intensive behavioral counseling, and 2400 euros for intensive behavioral counseling plus pharmacological treatment. The authors conclude that the combination of intensive behavioral counseling plus pharmacological treatment is the most successful and cost-effective treatment of smoking in COPD patients.Bartlett et al.<a class="elsevierStyleCrossRef" href="#bib0300">22</a> evaluated 17 randomized trials to determine what type of behavioral counseling for smoking cessation is most effective in smokers with COPD. This study identified 5 counseling techniques that are significantly associated with the best results: (1) action planning; (2) recording course of symptoms, achievements, and failures; (3) weight control; (4) social support; and (5) explaining clearly explain the relationship between COPD and smoking.Two clinical trials have examined the efficacy and safety of bupropion. One found that bupropion was more effective than placebo in achieving continuous abstinence at 6 months of follow-up (16% vs 9%; P<.05).<a class="elsevierStyleCrossRef" href="#bib0305">23</a> The other also showed similar results at 6 months of follow-up (difference of 18.9% [95% CI: 3.6–34.2]; P=.02.<a class="elsevierStyleCrossRef" href="#bib0310">24</a>The efficacy and safety of varenicline was analyzed in an RCT which found that varenicline was more effective than placebo for helping smokers to quit at 3, 6 and 12 months of follow-up. At the end of the year, the figures were 18.6% vs 5.6% (OR: 4.04 [95% CI: 2.13–7.67]; P<.0001).<a class="elsevierStyleCrossRef" href="#bib0315">25</a>A recent review analyzing 16 studies that included more than 13000 patients has reached similar conclusions to those discussed here.<a class="elsevierStyleCrossRef" href="#bib0320">26</a>Conclusions and RecommendationsThe available evidence indicates that the most effective intervention to help subjects with COPD to quit smoking is a combination of intensive behavioral counseling plus pharmacological treatment. This intervention is highly cost-effective.Behavioral counseling should be intensive and prolonged; the greater the intensity and the longer the duration, the greater the efficacy.A choice of NRT, bupropion or varenicline can be used as pharmacological treatment. Bupropion showed efficacy only at 6 months of follow-up. NRT and varenicline have been shown to be effective at 6 and 12 months of follow-up.High evidence and strong recommendation for intensive behavioral counseling plus pharmacological treatment (NRT and varenicline are superior to bupropion) to help smokers with COPD to quit.Grade of recommendation: 1A.PICO QuestionIs smoking cessation intervention effective in hospitalized smokers with COPD?RationaleAround 25%–35% of COPD patients admitted to hospital are smokers. Hospitalization is an ideal situation to help smokers quit. Taking into account these premises, hospitalization of an individual with COPD represents an important opportunity to determine their smoking status and to intervene decisively.<a class="elsevierStyleCrossRefs" href="#bib0325">27,28</a>Search SelectionSeven references were retrieved (MeSH: 3; Trip database: 1; and by snow-balling: 3), and 6 studies were selected to answer the question (3 RCTs, 1 systematic review, 1 economic evaluation, and 1 cohort study).Summary of EvidenceA systematic review found that intensive behavioral interventions that begin in the hospital and continue for at least 1 month after discharge increase abstinence rates (RR: 1.37; 95% CI: 1.27–1.48).<a class="elsevierStyleCrossRef" href="#bib0335">29</a> One study found that the combination of intensive intervention plus NRT increased abstinence rates compared with intensive intervention alone (RR: 1.54; 95% CI: 1.34–1.79). However, 2 other studies failed to show that adding varenicline or bupropion increases abstinence rates. Similar results were found in a subgroup of smokers who were admitted for cardiovascular diseases; in this subgroup, intensive intervention followed by subsequent support increased abstinence rates (RR: 1.42; 95% CI: 1.29–1.56) when compared with non-intensive intervention.Abstinence rates were compared in 2 groups of smokers enrolled in a clinical trial.<a class="elsevierStyleCrossRef" href="#bib0340">30</a> One group received intensive intervention (free pharmacological treatment for 90 days, regular phone calls and behavioral reinforcement), while the control group only received recommendations on the use of the medication at the time of discharge. Point prevalence abstinence at 6 months was significantly higher in the intervention group (26% vs 15%; RR: 1.71; 95% CI: 1.14–2.56; P=.009; NNT: 9.4; 95% CI: 6.4–35.5). The same was observed for continuous abstinence rates at 6 months (27% vs 16%; RR: 1.70; 95% CI: 1.15–2.51).A pharmacoeconomic study analyzed the cost-effectiveness of the Ottawa model for smoking cessation (OMSC) in patients hospitalized for various diseases, including COPD.<a class="elsevierStyleCrossRef" href="#bib0345">31</a> The OMSC includes psychological counseling and pharmacological treatment. The authors found that the OMSC program was very cost-effective with a 1-year cost per QALY gained of C$1386, and lifetime cost per QALY gained of C$68. The study showed that using the Ottawa model in 15326 hospitalized smokers in 1 year would achieve a total of 4689 quitters, and would prevent 116 re-hospitalizations, 923 hospital days, and 119 deaths in all of these chronic diseases.A clinical trial carried out by Borglykke et al.<a class="elsevierStyleCrossRef" href="#bib0350">32</a> compared the rates of abstinence in 2 groups of smokers with COPD attending the emergency department of a hospital. One group was randomized to receive intensive intervention and the other was the control group. Patients were followed up at 1 year and 3 years after the intervention. The results showed that at the 1-year follow-up, the abstinence rate in the intervention group was significantly higher than in the control group (30% vs 13%; OR: 2.83; 95% CI: 1.40–5.74). Moreover, no significant differences were found in terms of the amount of phlegm or survival (50.4% vs 43.1%; HR: 0.80; 95% CI: 0.55–1.16). However, at the 3-year follow-up, the intervention group had been hospitalized significantly fewer days for COPD or other causes.A clinical trial<a class="elsevierStyleCrossRef" href="#bib0355">33</a> randomized 172 patients to 2 groups. The intervention group received medical counseling for quitting smoking and screening for gastroesophageal reflux, depression and/or anxiety, in addition to education on the use of inhalers. Compared with the control group, the results showed no significant differences in readmissions or consultations within 30 days after discharge, or in the rate of readmissions at 90 days.Another study in a cohort of COPD patients hospitalized for exacerbations<a class="elsevierStyleCrossRef" href="#bib0360">34</a> reviewed the effectiveness of a brief anti-smoking counseling session during admission and the use of medication to assist smoking cessation after discharge. A total of 1334 patients were included: 19.8% reported having stopped smoking at 6 and 12 months of follow-up, 17.5% had no reported status, and 63.7% continued smoking. It is interesting to note that only 33.7% of the patients used smoking cessation medication. The results did not show higher rates of abstinence among those who received medication to quit smoking. Nor was any association found between anti-smoking counseling at the time of discharge and abstinence, or between those who received medication in the 48-h period after discharge or in those who had received treatment in the year prior to admission. Patients who received varenicline presented significantly higher rates of abstinence (OR: 2.44; 95% CI: 1.48–4.05), while those who received NRT in monotherapy showed the worst results (OR: 0.66; 95% CI: 0.51–0.85). Patients treated with bupropion or combination therapy were no more likely to report cessation.Conclusions and RecommendationsThe available evidence indicates that intensive intervention to help quit smoking initiated while the patient is hospitalized plus at least 1 month of follow-up after hospital discharge achieves higher abstinence rates when compared with smokers who received standard treatment. Effectiveness increases significantly when psychological counseling is added to treatment with NRT or varenicline. This intervention is highly cost-effective.High evidence and strong recommendation for initiating interventions to help COPD patients stop smoking during hospitalization.Grade of recommendation: 1A.PICO QuestionWould funding the treatment of smoking in smokers with COPD impact on health economics?RationaleCOPD places a considerable economic burden on public health systems. In Spain, costs amount to €3bn. a year. It is also known that the cost of care incurred by a smoker with COPD is approximately €3700/year, while individuals with COPD who have stopped smoking incur costs of €2000/year. Accordingly, then, when a smoker with COPD quits, savings to the National Health System amount to around €1300/year.<a class="elsevierStyleCrossRef" href="#bib0365">35</a>Search SelectionTwenty-two references were retrieved (MeSH: 17; Trip database: 5), and 4 studies were selected to answer the question (3 cohort studies and 1 case–control).Summary of EvidenceA case–control study conducted in Spain, in which costs generated by smokers with COPD were compared with those of former smokers with COPD over a 12-month period, found that the smokers with COPD consumed more health care resources compared to former smokers, regardless of their COPD severity stage.<a class="elsevierStyleCrossRef" href="#bib0365">35</a>Three simulated cohort studies in the United Kingdom, Spain and France have analyzed the scenario of funding smoking cessation in patients with COPD using a Markov model: (1) in COPD patients in the United Kingdom,<a class="elsevierStyleCrossRef" href="#bib0370">36</a> the ICER (incremental cost-effectiveness ratio) was £2686 per QALY and continued to yield savings after 10 years in all patients, regardless of COPD severity and percentage of success of the intervention applied; (2) in Spain,<a class="elsevierStyleCrossRef" href="#bib0375">37</a> the model was developed with a time horizon of 5 years and considered the 3 approved first-line drugs (varenicline, bupropion and NRT). Estimates were that 17756 COPD patients would give up smoking if the treatment were funded, compared to 1303 patients if it was not.<a class="elsevierStyleCrossRef" href="#bib0380">38</a> In the reimbursement scenario, accumulated savings would be €4.3 million; (3) in France, a cost-effectiveness study in patients with COPD, cancer, and cardiovascular disease allowed the authors to conclude that for a 5-year horizon, cost savings would be made in the range of €15–215 million with an ICER of €11187 per QALY.Conclusions and RecommendationsStudies analyzing the impact of funding of smoking cessation in patients with COPD make the following conclusions: (a) COPD patients who continue to smoke use more health care resources and generate greater social and economic costs; and (b) the funding of smoking cessation in smokers with COPD is highly effective and cost-effective.Moderate evidence and strong recommendation for the funding of the treatment of smoking in smokers with COPD, due to the impact on health and health economics.Grade of recommendation: 1B.Conflict of InterestsDr. Carlos A. Jiménez Ruiz has worked with GSK and Pfizer, pharmaceutical companies with an interest in the field of the treatment of smoking.Dr. Daniel Buljubasich has no conflict of interest.Dr. Juan A. Riesco Miranda has worked with GSK, Pfizer, Novartis, Boehringer Ingelheim and Astra-Zeneca in training and clinical research activities.Dr. Augustín Acuña Izcaray has received fees for lectures and/or scientific consultancy from Astra-Zeneca, Novartis and Pfizer.Dr. José Ignacio de Granda Orive has no conflict of interest.Dr. José Miguel Chatkin has no conflict of interest.Dr. Gustavo Zabert received fees for educational activities from Global Bridges and the InterAmerican Heart Foundation and for speaking engagements from Astra-Zeneca, Novartis, Boehringer Ingelheim, and Pfizer.Dr. Alfredo Guerreros Benavides has no conflict of interest.Dr. Nelson Paez Espinel has no conflict of interest.Mrs. Valeri Noah has no conflict of interest.Dr. Efraín Sánchez-Angarita has received fees for lectures at conferences and educational activities related to COPD treatment from Novartis, Boehringer Ingelheim, Takeda, and Pfizer.Dr. Ingrid Núñez-Sánchez has no conflict of interest.Dr. Dr. Raúl H. Sansores has no conflict of interest.Dr. Alejandro Casas has no conflict of interest.Dr. Andres Palomar Lever has received fees for speaking engagements from Novartis and Actelion.Dr. Inmaculada Alfageme Michavila has no conflict of interest." "textoCompletoSecciones" => array:1 [ "secciones" => array:12 [ 0 => array:3 [ "identificador" => "xres941033" "titulo" => "Abstract" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0005" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec914255" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres941032" "titulo" => "Resumen" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0010" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec914256" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Methodology" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Eligibility Criteria" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Critical Analysis and Formulation of Recommendations" ] ] ] 6 => array:3 [ "identificador" => "sec0025" "titulo" => "PICO Question" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0030" "titulo" => "Rationale" ] 1 => array:2 [ "identificador" => "sec0035" "titulo" => "Search Results" ] 2 => array:2 [ "identificador" => "sec0040" "titulo" => "Quality of Evidence" ] 3 => array:2 [ "identificador" => "sec0045" "titulo" => "Conclusions and Recommendations" ] ] ] 7 => array:3 [ "identificador" => "sec0050" "titulo" => "PICO Question" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0055" "titulo" => "Rationale" ] 1 => array:2 [ "identificador" => "sec0060" "titulo" => "Search Selection" ] 2 => array:2 [ "identificador" => "sec0065" "titulo" => "Summary of Evidence" ] 3 => array:2 [ "identificador" => "sec0070" "titulo" => "Conclusions and Recommendations" ] ] ] 8 => array:3 [ "identificador" => "sec0075" "titulo" => "PICO Question" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0080" "titulo" => "Rationale" ] 1 => array:2 [ "identificador" => "sec0085" "titulo" => "Search Selection" ] 2 => array:2 [ "identificador" => "sec0090" "titulo" => "Summary of Evidence" ] 3 => array:2 [ "identificador" => "sec0095" "titulo" => "Conclusions and Recommendations" ] ] ] 9 => array:3 [ "identificador" => "sec0100" "titulo" => "PICO Question" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0105" "titulo" => "Rationale" ] 1 => array:2 [ "identificador" => "sec0110" "titulo" => "Search Selection" ] 2 => array:2 [ "identificador" => "sec0115" "titulo" => "Summary of Evidence" ] 3 => array:2 [ "identificador" => "sec0120" "titulo" => "Conclusions and Recommendations" ] ] ] 10 => array:2 [ "identificador" => "sec0125" "titulo" => "Conflict of Interests" ] 11 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2016-12-06" "fechaAceptado" => "2017-04-09" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec914255" "palabras" => array:4 [ 0 => "Smoking" 1 => "Chronic obstructive pulmonary disease" 2 => "Treatment" 3 => "Spirometry" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec914256" "palabras" => array:4 [ 0 => "Tabaquismo" 1 => "Enfermedad pulmonar obstructiva crónica" 2 => "Tratamiento" 3 => "Espirometría" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "The ALAT and SEPAR Treatment and Control of Smoking Groups have collaborated in the preparation of this document which attempts to answer, by way of PICO methodology, different questions on health interventions for helping COPD patients to stop smoking.The main recommendations are: (i) moderate-quality evidence and strong recommendation for performing spirometry in COPD patients and in smokers with a high risk of developing the disease, as a motivational tool (particularly for showing evidence of lung age), a diagnostic tool, and for active case-finding; (ii) high-quality evidence and strong recommendation for using intensive dedicated behavioral counseling and drug treatment for helping COPD patients to stop smoking; (iii) high-quality evidence and strong recommendation for initiating interventions for helping COPD patients to stop smoking during hospitalization with improvement when the intervention is prolonged after discharge, and (iv) high-quality evidence and strong recommendation for funding treatment of smoking in COPD patients, in view of the impact on health and health economics." ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "Los grupos de control y tratamiento del tabaquismo de ALAT y SEPAR han colaborado para la realización de este documento en el que se da respuesta, siguiendo metodología PICO, a diferentes interrogantes relacionados con la asistencia sanitaria para ayudar a dejar de fumar a los pacientes con EPOC.Sus principales recomendaciones son: a) evidencia moderada y recomendación fuerte para realizar espirometría en pacientes con diagnóstico o en fumadores con alto riesgo de padecer EPOC, como instrumento de motivación, en particular evidenciando la edad pulmonar, y con fines diagnósticos y de búsqueda activa de casos; b) evidencia alta y recomendación fuerte para utilizar asesoramiento conductual intenso y específico y tratamiento farmacológico para ayudar a dejar de fumar a fumadores con EPOC; c) evidencia alta y recomendación fuerte para iniciar intervenciones para ayudar a dejar de fumar a fumadores con EPOC mientras se encuentran hospitalizados mejorando al mantener la intervención tras el alta, y d) evidencia alta y recomendación fuerte para la financiación del tratamiento del tabaquismo en fumadores con EPOC por su impacto sobre la salud y la economía de la salud." ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Jiménez Ruiz CA, Buljubasich D, Riesco Miranda JA, Acuña Izcaray A, de Granda Orive JI, Chatkin JM, et al. Preguntas y respuestas relacionadas con tabaquismo en pacientes con EPOC. Aplicación de metodología con formato PICO. Arch Bronconeumol. 2017;53:622–628." ] ] "multimedia" => array:2 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Clinical Question \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">PICO Question \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Search Strategy Using MeSH Terms \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " rowspan="2" align="left" valign="top">Does spirometry motivate the smoker with COPD to stop smoking?</td><td class="td" title="table-entry " align="left" valign="top">(a) P=COPD or Chronic Obstructive Pulmonary Disease I=Smoking Cessation C=Ø O=Lung age \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">((((“pulmonary disease, chronic obstructive” [MeSH Terms] OR COPD OR Chronic Obstructive Pulmonary Disease OR COAD OR Chronic Obstructive Airway Disease OR Chronic Obstructive Lung Disease OR Airflow Obstruction, Chronic OR Airflow Obstructions, Chronic OR Chronic Airflow Obstructions OR Chronic Airflow Obstruction))) AND “Smoking Cessation” [MeSH]) AND lung age \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">(b) P=COPD or Chronic Obstructive Pulmonary Disease I=Smoking Cessation C=Ø O=(“Spirometry” [MeSH] OR Spirometries) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">((((((“pulmonary disease, chronic obstructive” [MeSH Terms] OR COPD OR Chronic Obstructive Pulmonary Disease OR COAD OR Chronic Obstructive Airway Disease OR Chronic Obstructive Lung Disease OR Airflow Obstruction, Chronic OR Airflow Obstructions, Chronic OR Chronic Airflow Obstructions OR Chronic Airflow Obstruction))))) AND ((cessation, smoking OR cessations, smoking OR smoking cessation) OR “Smoking Cessation” [MeSH])) AND (“Spirometry” [MeSH] OR Spirometries) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " rowspan="2" align="left" valign="top">Is the treatment of smoking different between smokers with and without COPD?</td><td class="td" title="table-entry " align="left" valign="top">(a) P=COPD or Chronic Obstructive Pulmonary Disease I=Smoking Cessation C=Ø O=Ø \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " rowspan="2" align="left" valign="top">(((((“pulmonary disease, chronic obstructive” [MeSH Terms] OR COPD OR Chronic Obstructive Pulmonary Disease OR COAD OR Chronic Obstructive Airway Disease OR Chronic Obstructive Lung Disease OR Airflow Obstruction, Chronic OR Airflow Obstructions, Chronic OR Chronic Airflow Obstructions OR Chronic Airflow Obstruction))))) AND ((cessation, smoking OR cessations, smoking OR smoking cessation) OR “Smoking Cessation” [MeSH]) by relevance</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">(b) P=Smokers with COPD versus Smokers without COPD I=Smoking cessation treatment C=Ø O=Ø \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " rowspan="2" align="left" valign="top">Is smoking cessation intervention effective in hospitalized smokers with COPD?</td><td class="td" title="table-entry " align="left" valign="top">(a) P=COPD or Chronic Obstructive Pulmonary Disease I=Smoking Cessation C=Ø O=Hospitalization \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " rowspan="2" align="left" valign="top">(((((((“pulmonary disease, chronic obstructive” [MeSH Terms] OR COPD OR Chronic Obstructive Pulmonary Disease OR COAD OR Chronic Obstructive Airway Disease OR Chronic Obstructive Lung Disease OR Airflow Obstruction, Chronic OR Airflow Obstructions, Chronic OR Chronic Airflow Obstructions OR Chronic Airflow Obstruction))))) AND ((cessation, smoking OR cessations, smoking OR smoking cessation) OR “Smoking Cessation” [MeSH]))) AND (“Hospitalization” [MeSH] OR hospitalizations OR hospitalized) Sort by: Relevance</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">(b) P=COPD or Chronic Obstructive Pulmonary Disease I=Smoking Cessation C=Ø O=Exacerbation \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Would funding the treatment of smoking in smokers with COPD impact on health economics? \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">P=COPD or Chronic Obstructive Pulmonary Disease I=Smoking Cessation C=Ø O=financing OR price OR pay OR incentives \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">((((((“pulmonary disease, chronic obstructive” [MeSH Terms] OR COPD OR Chronic Obstructive Pulmonary Disease OR COAD OR Chronic Obstructive Airway Disease OR Chronic Obstructive Lung Disease OR Airflow Obstruction, Chronic OR Airflow Obstructions, Chronic OR Chronic Airflow Obstructions OR Chronic Airflow Obstruction))))) AND ((cessation, smoking OR cessations, smoking OR smoking cessation) OR “Smoking Cessation” [MeSH])) AND (financing OR price OR pay OR incentives) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1592596.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Search Strategy (Trip Database Key Words and MeSH Terms)." ] ] 1 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Clinical Question \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total References Selected \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total References Retrieved from Trip \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total References Retrieved from MeSH \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total References Selected to Answer the Question \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Types of Study Selected \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Does spirometry motivate the smoker with COPD to stop smoking? \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">31 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">26 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 systematic reviews<a class="elsevierStyleCrossRefs" href="#bib0240">10,11</a> 4 RCTs<a class="elsevierStyleCrossRefs" href="#bib0250">12,14–16</a> 1 cohort study<a class="elsevierStyleCrossRef" href="#bib0255">13</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Is the treatment of smoking different between smokers with and without COPD? \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">27 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">22 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3 systematic reviews<a class="elsevierStyleCrossRefs" href="#bib0275">17–19</a> 2 meta-analyses<a class="elsevierStyleCrossRefs" href="#bib0290">20,22</a> 4 RCTs<a class="elsevierStyleCrossRefs" href="#bib0295">21,23–25</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Is smoking cessation intervention effective in hospitalized smokers with COPD? \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 systematic review<a class="elsevierStyleCrossRef" href="#bib0335">29</a> 3 RCTs<a class="elsevierStyleCrossRefs" href="#bib0340">30,32,33</a> 1 economic evaluation<a class="elsevierStyleCrossRef" href="#bib0345">31</a> 1 cohort study<a class="elsevierStyleCrossRef" href="#bib0360">34</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Would funding the treatment of smoking in smokers with COPD impact on health economics? \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">22 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">17 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 case–control study<a class="elsevierStyleCrossRef" href="#bib0365">35</a> 3 cohort studies<a class="elsevierStyleCrossRefs" href="#bib0370">36–38</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1592597.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "Manual capture by snow-balling: 3 references." ] ] ] "descripcion" => array:1 [ "en" => "Number and Type of Studies Selected to Answer the Clinical Questions." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:38 [ 0 => array:3 [ "identificador" => "bib0195" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Global Strategy for Diagnosis, Management, and Prevention of COPD-2016. Available from: <a href="http://www.goldcopd.org/Guidelines/guidelines-resources.html">http://www.goldcopd.org/Guidelines/guidelines-resources.html</a> [accessed 17.04.16]." ] ] ] 1 => array:3 [ "identificador" => "bib0200" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Smoking cessation in COPD" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "P. Tonnesen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1183/09059180.00007212" "Revista" => array:6 [ "tituloSerie" => "Eur Respir Rev" "fecha" => "2013" "volumen" => "22" "paginaInicial" => "37" "paginaFinal" => "43" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23457163" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0205" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Normativa SEPAR. Tratamiento del tabaquismo en fumadores con EPOC" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C.A. Jimenez Ruiz" 1 => "J.A. Riesco Miranda" 2 => "N. Altet Gómez" 3 => "J.J. Lorza Blasco" 4 => "J. Signes-Costa Miñana" 5 => "S. Solano Reina" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.arbres.2013.02.005" "Revista" => array:6 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "2013" "volumen" => "49" "paginaInicial" => "354" "paginaFinal" => "363" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23642760" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0210" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Statement on smoking cessation on COPD and other pulmonary diseases and in smokers with co-morbidities who find it difficult to quit" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C.A. Jimenez Ruiz" 1 => "S. Andreas" 2 => "K.E. Lewis" 3 => "P. Tonnesen" 4 => "C.P. van Schayck" 5 => "P. Hajek" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1183/09031936.00092614" "Revista" => array:6 [ "tituloSerie" => "Eur Respir J" "fecha" => "2015" "volumen" => "46" "paginaInicial" => "61" "paginaFinal" => "79" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25882805" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0215" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Smoking cessation strategies in patients with COPD" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M.J. Warniers" 1 => "E.E. van Riet" 2 => "F.H. Rutten" 3 => "M.L. de Bruin" 4 => "A.P. Sachs" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Eur Respir J" "fecha" => "2013" "volumen" => "41" "paginaInicial" => "27" "paginaFinal" => "34" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0220" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Smoking cessation in chronic obstructive pulmonary disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "D.P. Tashkin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1055/s-0035-1555610" "Revista" => array:6 [ "tituloSerie" => "Semin Respir Crit Care Med" "fecha" => "2015" "volumen" => "36" "paginaInicial" => "491" "paginaFinal" => "507" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26238637" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0225" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "GRADE guidelines: 2. Framing the question and deciding on important outcomes" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "G.H. Guyatt" 1 => "A.D. Oxman" 2 => "R. Kunz" 3 => "D. Atkins" 4 => "J. Brozek" 5 => "G. Vist" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jclinepi.2010.09.012" "Revista" => array:6 [ "tituloSerie" => "J Clin Epidemiol" "fecha" => "2011" "volumen" => "64" "paginaInicial" => "395" "paginaFinal" => "400" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21194891" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0230" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Evidence-based medicine workbook. Finding and applying the best evidence to improve patient care" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "P. Glasziou" 1 => "C.H. del Mar" 2 => "J. Salisbury" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:2 [ "fecha" => "2003" "editorial" => "BMJ Books" ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0235" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Grading strength of recommendations and quality of evidence in clinical guidelines: report from an American College of Chest Physicians Task Force" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "G. Guyatt" 1 => "D. Gutterman" 2 => "M.H. Baumann" 3 => "D. Addrizzo-Harris" 4 => "E.M. Hylek" 5 => "B. Phillips" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1378/chest.129.1.174" "Revista" => array:6 [ "tituloSerie" => "Chest" "fecha" => "2006" "volumen" => "129" "paginaInicial" => "174" "paginaFinal" => "181" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16424429" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0240" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Spirometry as a motivational tool to improve smoking cessation rates: a systematic review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "T.J. Wilt" 1 => "D. Niewoehner" 2 => "R.L. Kane" 3 => "R. MacDonald" 4 => "A.M. Joseph" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1080/14622200601078509" "Revista" => array:6 [ "tituloSerie" => "Nicotine Tob Res" "fecha" => "2007" "volumen" => "9" "paginaInicial" => "21" "paginaFinal" => "32" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17365733" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0245" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "CD004705" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Biomedical risk assessment as an aid for smoking cessation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "R. Bize" 1 => "B. Burnand" 2 => "Y. Mueller" 3 => "M. RègeWalther" 4 => "J. Cornuz" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:3 [ "tituloSerie" => "Cochrane Database Syst Rev" "fecha" => "2009" "volumen" => "15" ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0250" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effectiveness of individual counselling for smoking cessation in smokers with chronic obstructive pulmonary disease and asymptomatic smokers" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J. Chen" 1 => "Y. Chen" 2 => "P. Chen" 3 => "Z. Liu" 4 => "H. Luo" 5 => "S. Cai" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3892/etm.2013.1463" "Revista" => array:6 [ "tituloSerie" => "Exp Ther Med" "fecha" => "2014" "volumen" => "7" "paginaInicial" => "716" "paginaFinal" => "720" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24520273" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0255" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Smokers with airway obstruction are more likely to quit smoking" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Bednarek" 1 => "D. Gorecka" 2 => "J. Wielgomas" 3 => "M. Czajkowska-Malinowska" 4 => "J. Regula" 5 => "G. Mieszko-Filipczyk" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/thx.2006.059071" "Revista" => array:6 [ "tituloSerie" => "Thorax" "fecha" => "2006" "volumen" => "61" "paginaInicial" => "869" "paginaFinal" => "873" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16809415" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0260" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The impact of repeated spirometry and smoking cessation advice on smokers with mild COPD" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "G. Stratelis" 1 => "S. Mölstad" 2 => "P. Jakobsson" 3 => "O. Zetterström" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Scan J Prim Health Care" "fecha" => "2006" "volumen" => "24" "paginaInicial" => "133" "paginaFinal" => "139" "itemHostRev" => array:3 [ "pii" => "S074980631300159X" "estado" => "S300" "issn" => "07498063" ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0265" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effect on smoking quit rate of telling patients their lung age: the Step2quit randomised controlled trial" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "G. Parker" 1 => "T. Greenhalgh" 2 => "M. Griffin" 3 => "R. Dem" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/bmj.39503.582396.25" "Revista" => array:6 [ "tituloSerie" => "BMJ" "fecha" => "2008" "volumen" => "336" "paginaInicial" => "598" "paginaFinal" => "600" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18326503" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0270" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Efficacy of confronting smokers with air flow limitation for smoking cessation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "D. Kotz" 1 => "G. Wesseling" 2 => "M.J. Huibers" 3 => "O.C. van Schayck" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1183/09031936.00116308" "Revista" => array:6 [ "tituloSerie" => "Eur Respir J" "fecha" => "2009" "volumen" => "33" "paginaInicial" => "754" "paginaFinal" => "762" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19129277" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0275" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "CD002999" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Smoking cessation for chronic obstructive pulmonary disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "R.M. Van der Meer" 1 => "E. Wagena" 2 => "R.W.J.G. Ostelo" 3 => "A.J.E. Jacobs" 4 => "C.P. van Schayck" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:2 [ "tituloSerie" => "Cochrane Database Syst Rev" "fecha" => "2003" ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0280" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Long term effectiveness and cost/effectiveness of smoking cessation interventions in patients with COPD" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M. Hoogendoon" 1 => "T.L. Feenstra" 2 => "R.T. Hoogenveen" 3 => "M. Rutten-van Mölken" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/thx.2009.131631" "Revista" => array:6 [ "tituloSerie" => "Thorax" "fecha" => "2010" "volumen" => "65" "paginaInicial" => "711" "paginaFinal" => "718" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20685746" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0285" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "Available from: http://www.hqontario.ca/en/mas/tech/pdfs/2012/rev_COPD_Smoking_Cessation_March.pdf [accessed 06.10.16]" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Smoking cessation for patients with chronic obstructive pulmonary disease: an evidence-based analyses" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "COPD Working Group" "etal" => false "autores" => array:1 [ 0 => "M. Thabane" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ont Health Technol Assess Ser" "fecha" => "2012" "volumen" => "12" "paginaInicial" => "1" "paginaFinal" => "75" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23226812" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0290" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Smoking cessation interventions in COPD: a network meta-analysis of randomized trials" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "R. Strassman" 1 => "B. Bausch" 2 => "A. Spaar" 3 => "J. Kleijnen" 4 => "O. Braendli" 5 => "M.A. Puhan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1183/09031936.00167708" "Revista" => array:6 [ "tituloSerie" => "Eur Respir J" "fecha" => "2009" "volumen" => "34" "paginaInicial" => "634" "paginaFinal" => "640" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19357145" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0295" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "High rates of smoking abstinence in COPD patients: smoking cessation by hospitalization" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "B.M. Sundblad" 1 => "K. Larsson" 2 => "L. Nathell" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1080/14622200802023890" "Revista" => array:6 [ "tituloSerie" => "Nicotine Tob Res" "fecha" => "2008" "volumen" => "10" "paginaInicial" => "883" "paginaFinal" => "890" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18569763" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0300" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effective behaviour change techniques in smoking cessation interventions for people with chronic obstructive pulmonary disease: a meta-analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Y.L. Bartlett" 1 => "P. Sheeran" 2 => "M.S. Hawley" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/bjhp.12071" "Revista" => array:6 [ "tituloSerie" => "Br J Health Psychol" "fecha" => "2014" "volumen" => "19" "paginaInicial" => "181" "paginaFinal" => "203" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24397814" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0305" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Smoking cessation in patients with chronic obstructive pulmonary disease: a double-blind, placebo-controlled, randomised trial" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D.P. Tashkin" 1 => "R. Kanner" 2 => "W. Bailey" 3 => "S. Buist" 4 => "P. Anderson" 5 => "M. Nides" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Lancet" "fecha" => "2001" "volumen" => "357" "paginaInicial" => "1571" "paginaFinal" => "1575" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11377644" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S1058274613004321" "estado" => "S300" "issn" => "10582746" ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0310" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Efficacy of bupropion and nortriptyline for smoking cessation among people at risk for or with COPD" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "E.J. Wagena" 1 => "P.G. Knispchild" 2 => "M.J. Huibers" 3 => "E.F. Wouters" 4 => "C.P. van Schayk" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/archinte.165.19.2286" "Revista" => array:7 [ "tituloSerie" => "Arch Intern Med" "fecha" => "2005" "volumen" => "165" "paginaInicial" => "2286" "paginaFinal" => "2292" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16246996" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S1058274614003267" "estado" => "S300" "issn" => "10582746" ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0315" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effects of varenicline on smoking cessation in patients with mild to moderate COPD: a randomized controlled trial" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "D.P. Tashkin" 1 => "S. Rennard" 2 => "J.T. Hays" 3 => "D. Lawrence" 4 => "J.P. Marton" 5 => "T.C. Lee" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1378/chest.10-0865" "Revista" => array:6 [ "tituloSerie" => "Chest" "fecha" => "2011" "volumen" => "139" "paginaInicial" => "591" "paginaFinal" => "599" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20864613" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0320" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "CD010744" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Smoking cessation for people with chronic obstructive pulmonary disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "E.A. Van Eerd" 1 => "R.M. van der Meer" 2 => "O.C. van Schayck" 3 => "D. Kotz" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:2 [ "tituloSerie" => "Cochrane Database Syst Rev" "fecha" => "2016" ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0325" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Depressive symptoms and chronic obstructive pulmonary disease: effect on mortality, hospital readmission, symptom burden, functional status, and quality of life" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "T.P. Ng" 1 => "M. Niti" 2 => "W.C. Tan" 3 => "Z. Cao" 4 => "K.C. Ong" 5 => "P. Eng" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/archinte.167.1.60" "Revista" => array:7 [ "tituloSerie" => "Arch Intern Med" "fecha" => "2007" "volumen" => "167" "paginaInicial" => "60" "paginaFinal" => "67" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17210879" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0749806316002668" "estado" => "S300" "issn" => "07498063" ] ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib0330" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "Traducción al español: Guía de tratamiento del tabaquismo (Jiménez Ruiz CA, Jaén CR, coordinadores de la traducción). Sociedad Española de Neumología y Cirugía Torácica. SEPAR. Mayo 2010. Eden Artes Gráficas S.L., Madrid: 2010." "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treating tobacco use dependence: 2008 update. Clinical practice guideline" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.C. Fiore" 1 => "C.R. Jaén" 2 => "T.B. Baker" 3 => "W.C. Baily" 4 => "N. Benowitz" 5 => "S.J. Curry" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2008" "editorial" => "U.S. Department of Health and Human Services, Public Health Service" "editorialLocalizacion" => "Rockville, MD" ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib0335" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "Issue 5 Art. No.: CD001837" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Interventions for smoking cessation in hospitalised patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "N.A. Rigotti" 1 => "C. Clair" 2 => "M.R. Munafò" 3 => "L.F. Stead" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:2 [ "tituloSerie" => "Cochrane Database Syst Rev" "fecha" => "2012" ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib0340" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sustained care intervention and postdischarge smoking cessation among hospitalized adults: a randomized clinical trial" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "N.A. Rigotti" 1 => "S. Regan" 2 => "D.E. Levy" 3 => "S. Japuntich" 4 => "Y. Chang" 5 => "E.R. Park" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/jama.2014.9237" "Revista" => array:6 [ "tituloSerie" => "JAMA" "fecha" => "2014" "volumen" => "312" "paginaInicial" => "719" "paginaFinal" => "728" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25138333" "web" => "Medline" ] ] ] ] ] ] ] ] 30 => array:3 [ "identificador" => "bib0345" "etiqueta" => "31" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Economic evaluation of a hospital-initiated intervention for smokers with chronic disease, in Ontario, Canada" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "K.A. Mullen" 1 => "D. Coyle" 2 => "D. Manuel" 3 => "H.V. Nguyen" 4 => "B. Pham" 5 => "A.L. Pipe" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/tobaccocontrol-2013-051483" "Revista" => array:6 [ "tituloSerie" => "Tob Control" "fecha" => "2015" "volumen" => "24" "paginaInicial" => "489" "paginaFinal" => "496" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24935442" "web" => "Medline" ] ] ] ] ] ] ] ] 31 => array:3 [ "identificador" => "bib0350" "etiqueta" => "32" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The effectiveness of smoking cessation groups offered to hospitalised patients with symptoms of exacerbations of chronic obstructive pulmonary disease (COPD)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A. Borglykke" 1 => "C. Pisinger" 2 => "T. Jørgensen" 3 => "H. Ibsen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1752-699X.2008.00055.x" "Revista" => array:6 [ "tituloSerie" => "Clin Respir J" "fecha" => "2008" "volumen" => "2" "paginaInicial" => "158" "paginaFinal" => "165" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20298324" "web" => "Medline" ] ] ] ] ] ] ] ] 32 => array:3 [ "identificador" => "bib0355" "etiqueta" => "33" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Predischarge bundle for patients with acute exacerbations of COPD to reduce readmissions and ED visits. A randomized controlled trial" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J. Jennings" 1 => "K. Thavarajah" 2 => "M.P. Mendez" 3 => "M. Eichenhorn" 4 => "P. Kvale" 5 => "L. Yessayan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1378/chest.14-1123" "Revista" => array:6 [ "tituloSerie" => "Chest" "fecha" => "2015" "volumen" => "147" "paginaInicial" => "1227" "paginaFinal" => "1234" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25940250" "web" => "Medline" ] ] ] ] ] ] ] ] 33 => array:3 [ "identificador" => "bib0360" "etiqueta" => "34" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Utilization and effectiveness of pharmacotherapy for tobacco use following admission for exacerbation of COPD" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A.C. Melzer" 1 => "L.C. Feemster" 2 => "M.P. Collins" 3 => "D.H. Au" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/jhm.2519" "Revista" => array:6 [ "tituloSerie" => "J Hosp Med" "fecha" => "2016" "volumen" => "11" "paginaInicial" => "257" "paginaFinal" => "263" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26663891" "web" => "Medline" ] ] ] ] ] ] ] ] 34 => array:3 [ "identificador" => "bib0365" "etiqueta" => "35" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The effect of quitting smoking on costs and healthcare utilization in patients with chronic obstructive pulmonary disease: a comparison of current smokers versus ex-smokers in routine clinical practice" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M. Sicras-Mainar" 1 => "J. Rejas-Gutiérrez" 2 => "R. Navarro-Artieda" 3 => "J. Ibáñez-Nolla" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Lung" "fecha" => "2014" "volumen" => "1" "paginaInicial" => "505" "paginaFinal" => "518" ] ] ] ] ] ] 35 => array:3 [ "identificador" => "bib0370" "etiqueta" => "36" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "e24870" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Simulation-based estimates of effectiveness and cost-effectiveness of smoking cessation in patients with chronic obstructive pulmonary disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "K. Atsou" 1 => "C. Chouaid" 2 => "G. Hejblum" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1371/journal.pone.0028413" "Revista" => array:4 [ "tituloSerie" => "PLoS ONE" "fecha" => "2011" "volumen" => "6" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22162769" "web" => "Medline" ] ] ] ] ] ] ] ] 36 => array:3 [ "identificador" => "bib0375" "etiqueta" => "37" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Budgetary impact analysis on funding smoking-cessation drugs in patients with COPD in Spain" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C. Jimenez-Ruiz" 1 => "S. Solano-Reina" 2 => "J. Signes-Costa" 3 => "E. de Higes-Martinez" 4 => "J.I. Granda-Orive" 5 => "J.J. Lorza-Blasco" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2147/COPD.S87597" "Revista" => array:6 [ "tituloSerie" => "Int J Chron Obstruct Pulmon Dis" "fecha" => "2015" "volumen" => "10" "paginaInicial" => "2027" "paginaFinal" => "2036" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26451100" "web" => "Medline" ] ] ] ] ] ] ] ] 37 => array:3 [ "identificador" => "bib0380" "etiqueta" => "38" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cost effectiveness of free access to smoking cessation treatment in France considering the economic burden of smoking related diseases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "B. Cadler" 1 => "I. Durand-Zaleski" 2 => "D. Thomas" 3 => "K. Chevreul" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1371/journal.pone.0148750" "Revista" => array:5 [ "tituloSerie" => "PLOS ONE" "fecha" => "2016" "volumen" => "11" "paginaInicial" => "e0148750" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26909802" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:3 [ "titulo" => "Acknowledgements" "texto" => "We thank Dr. Ángela Ramos Pinedo (Hospital Fundación Alcorcón, Madrid, Spain) and Dr. Susana Luhning (Professor of the Department of Internal Medicine/Respiratory Medicine, Facultad de Medicina, Universidad de Córdoba, Argentina), who acted as external reviewers of this document." "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/15792129/0000005300000011/v2_201711201359/S1579212917302987/v2_201711201359/en/main.assets" "Apartado" => array:4 [ "identificador" => "47123" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Special Article" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15792129/0000005300000011/v2_201711201359/S1579212917302987/v2_201711201359/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212917302987?idApp=UINPBA00003Z"]

Statistics

Special article

Using PICO Methodology to Answer Questions About Smoking in COPD Patients

Preguntas y respuestas relacionadas con tabaquismo en pacientes con EPOC. Aplicación de metodología con formato PICO

Carlos A. Jiménez Ruiza,

Corresponding author

victorina@ctv.es

Corresponding author.

, Daniel Buljubasichb, Juan Antonio Riesco Mirandac, Agustín Acuña Izcarayd, José Ignacio de Granda Orivee, José Miguel Chatkinf, Gustavo Zabertg, Alfredo Guerreros Benavidesh, Nelson Paez Espineli, Valeri Noéj, Efraín Sánchez-Angaritak, Ingrid Núñez-Sánchezl, Raúl H. Sansoresj, Alejandro Casasm, Andrés Palomar Levern, Inmaculada Alfageme Michavilao

a Unidad Especializada en Tabaquismo, PII Tabaquismo SEPAR, Madrid, Spain

b Servicio de Neumología, Hospital Español, Grupo Tabaquismo ALAT Rosario, Argentina

c Servicio de Neumología, Hospital San Pedro de Alcántara, Cáceres, Spain

d Hospital Universitario de Caracas, Universidad Central de Venezuela, Centro Médico Docente La Trinidad, Caracas, Venezuela

e Servicio de Neumología, Hospital Universitario 12 de Octubre, Área de Tabaquismo SEPAR, Madrid, Spain

f Medicina Interna, Faculdade de Medicina, Pontificia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil

g Asociación Latinoamericana del Tórax, Facultad de Ciencias Médicas, Universidad Nacional del Comahue, Neuquén, Argentina

h Facultad de Medicina San Fernando, Universidad Nacional Mayor de San Marcos, Sociedad Peruana de Neumología, Lima, Peru

i Fundación Neumológica Colombiana, Programa de cesación de Tabaquismo “Exfumaire”, Universidad de La Sabana, Chía, Colombia

j Departamento de Investigación en Tabaquismo y EPOC, Instituto Nacional de Enfermedades Respiratorias, Ciudad de México, Mexico

k Servicio de Neumología, Hospital Universitario de Caracas, Universidad Central de Venezuela, Centro Médico docente La Trinidad, Caracas, Venezuela

l Servicio de Neumología y Cirugía de Tórax, Hospital Universitario de Caracas, Universidad Central de Venezuela, Caracas, Venezuela

m Universidad del Rosario, Fundación Neumológica Colombiana, Bogotá, Colombia

n Centro médico ABC de la Ciudad de México, Escuela de Medicina del TEC de Monterrey Campus ABC de la Ciudad México, Ciudad de México, Mexico

o Hospital Universitario Virgen de Valme, Universidad de Sevilla, SEPAR, Sevilla, Spain

Read

13516

Times
was read the article

2979

Total PDF

10537

Total HTML

Share statistics

 array:24 [
  "pii" => "S1579212917302987"
  "issn" => "15792129"
  "doi" => "10.1016/j.arbr.2017.04.018"
  "estado" => "S300"
  "fechaPublicacion" => "2017-11-01"
  "aid" => "1620"
  "copyright" => "SEPAR"
  "copyrightAnyo" => "2017"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "fla"
  "cita" => "Arch Bronconeumol. 2017;53:622-8"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:2 [
    "total" => 2796
    "formatos" => array:3 [
      "EPUB" => 167
      "HTML" => 1825
      "PDF" => 804
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S0300289617301333"
      "issn" => "03002896"
      "doi" => "10.1016/j.arbres.2017.04.012"
      "estado" => "S300"
      "fechaPublicacion" => "2017-11-01"
      "aid" => "1620"
      "copyright" => "SEPAR"
      "documento" => "article"
      "crossmark" => 1
      "subdocumento" => "fla"
      "cita" => "Arch Bronconeumol. 2017;53:622-8"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 5760
        "formatos" => array:3 [
          "EPUB" => 166
          "HTML" => 4682
          "PDF" => 912
        ]
      ]
      "es" => array:12 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Art&#237;culo especial</span>"
        "titulo" => "Preguntas y respuestas relacionadas con tabaquismo en pacientes con EPOC&#46; Aplicaci&#243;n de metodolog&#237;a con formato PICO"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "tieneResumen" => array:2 [
          0 => "es"
          1 => "en"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "622"
            "paginaFinal" => "628"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Using PICO Methodology to Answer Questions About Smoking in COPD Patients"
          ]
        ]
        "contieneResumen" => array:2 [
          "es" => true
          "en" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Carlos A&#46; Jim&#233;nez Ruiz, Daniel Buljubasich, Juan Antonio Riesco Miranda, Agust&#237;n Acu&#241;a Izcaray, Jos&#233; Ignacio de Granda Orive, Jos&#233; Miguel Chatkin, Gustavo Zabert, Alfredo Guerreros Benavides, Nelson Paez Espinel, Valeri No&#233;, Efra&#237;n S&#225;nchez-Angarita, Ingrid N&#250;&#241;ez-S&#225;nchez, Ra&#250;l H&#46; Sansores, Alejandro Casas, Andr&#233;s Palomar Lever, Inmaculada Alfageme Michavila"
            "autores" => array:16 [
              0 => array:2 [
                "nombre" => "Carlos A&#46;"
                "apellidos" => "Jim&#233;nez Ruiz"
              ]
              1 => array:2 [
                "nombre" => "Daniel"
                "apellidos" => "Buljubasich"
              ]
              2 => array:2 [
                "nombre" => "Juan Antonio"
                "apellidos" => "Riesco Miranda"
              ]
              3 => array:2 [
                "nombre" => "Agust&#237;n"
                "apellidos" => "Acu&#241;a Izcaray"
              ]
              4 => array:2 [
                "nombre" => "Jos&#233; Ignacio"
                "apellidos" => "de Granda Orive"
              ]
              5 => array:2 [
                "nombre" => "Jos&#233; Miguel"
                "apellidos" => "Chatkin"
              ]
              6 => array:2 [
                "nombre" => "Gustavo"
                "apellidos" => "Zabert"
              ]
              7 => array:2 [
                "nombre" => "Alfredo"
                "apellidos" => "Guerreros Benavides"
              ]
              8 => array:2 [
                "nombre" => "Nelson"
                "apellidos" => "Paez Espinel"
              ]
              9 => array:2 [
                "nombre" => "Valeri"
                "apellidos" => "No&#233;"
              ]
              10 => array:2 [
                "nombre" => "Efra&#237;n"
                "apellidos" => "S&#225;nchez-Angarita"
              ]
              11 => array:2 [
                "nombre" => "Ingrid"
                "apellidos" => "N&#250;&#241;ez-S&#225;nchez"
              ]
              12 => array:2 [
                "nombre" => "Ra&#250;l H&#46;"
                "apellidos" => "Sansores"
              ]
              13 => array:2 [
                "nombre" => "Alejandro"
                "apellidos" => "Casas"
              ]
              14 => array:2 [
                "nombre" => "Andr&#233;s"
                "apellidos" => "Palomar Lever"
              ]
              15 => array:2 [
                "nombre" => "Inmaculada"
                "apellidos" => "Alfageme Michavila"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S1579212917302987"
          "doi" => "10.1016/j.arbr.2017.04.018"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => false
            "ES2" => false
            "LATM" => false
          ]
          "gratuito" => false
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212917302987?idApp=UINPBA00003Z"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289617301333?idApp=UINPBA00003Z"
      "url" => "/03002896/0000005300000011/v1_201710310034/S0300289617301333/v1_201710310034/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S1579212917303026"
    "issn" => "15792129"
    "doi" => "10.1016/j.arbr.2017.09.004"
    "estado" => "S300"
    "fechaPublicacion" => "2017-11-01"
    "aid" => "1631"
    "copyright" => "SEPAR"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "ssu"
    "cita" => "Arch Bronconeumol. 2017;53:629-36"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 6923
      "formatos" => array:3 [
        "EPUB" => 196
        "HTML" => 5590
        "PDF" => 1137
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Review article</span>"
      "titulo" => "Diagnosis and Management of Pleural Transudates"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "629"
          "paginaFinal" => "636"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Diagn&#243;stico y manejo de los trasudados pleurales"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Fig&#46; 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 4143
              "Ancho" => 2167
              "Tamanyo" => 565685
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Schematic representation of the movement of fluid in the pleural space in normal conditions &#40;A&#41;&#44; in heart failure &#40;B&#41; and in trapped lung &#40;C&#41;&#46; In normal lung and pleura &#40;A&#41;&#44; the balance of hydrostatic and oncotic pressures promotes the formation of pleural fluid&#46; Pressure gradients show a net flow of fluid from the parietal pleura and that balance is maintained in the visceral pleura &#40;pressures in cmH<span class="elsevierStyleInf">2</span>O&#41;&#46; In heart failure &#40;B&#41;&#44; fluid in the pulmonary interstitium increases due to increased pulmonary capillary pressures&#46; Fluid that enters the pleural space exceeds the drainage capacity of the pleural lymphatic capillaries&#46; In trapped lung &#40;C&#41;&#44; a previous inflammatory process has produced a thick&#44; fibrous visceral pleura&#46; The inability of the lung to expand leads to a negative hydrostatic pleural pressure and this alteration of the Starling&#39;s forces leads to the formation of pleural transudate&#46; Pleural effusion may be verging on exudate&#44; depending on how recent the active inflammation was&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Luc&#237;a Ferreiro, Jos&#233; M&#46; Porcel, Luis Vald&#233;s"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "Luc&#237;a"
              "apellidos" => "Ferreiro"
            ]
            1 => array:2 [
              "nombre" => "Jos&#233; M&#46;"
              "apellidos" => "Porcel"
            ]
            2 => array:2 [
              "nombre" => "Luis"
              "apellidos" => "Vald&#233;s"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0300289617301461"
        "doi" => "10.1016/j.arbres.2017.04.018"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289617301461?idApp=UINPBA00003Z"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212917303026?idApp=UINPBA00003Z"
    "url" => "/15792129/0000005300000011/v2_201711201359/S1579212917303026/v2_201711201359/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S1579212917303075"
    "issn" => "15792129"
    "doi" => "10.1016/j.arbr.2017.09.006"
    "estado" => "S300"
    "fechaPublicacion" => "2017-11-01"
    "aid" => "1600"
    "copyright" => "SEPAR"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "Arch Bronconeumol. 2017;53:616-21"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 1376
      "formatos" => array:3 [
        "EPUB" => 139
        "HTML" => 897
        "PDF" => 340
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
      "titulo" => "Relationship Between Chronic Obstructive Pulmonary Disease and Air Pollutants Depending on the Origin and Trajectory of Air Masses in the North of Spain"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "616"
          "paginaFinal" => "621"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "An&#225;lisis de la relaci&#243;n entre la enfermedad pulmonar obstructiva cr&#243;nica y los contaminantes atmosf&#233;ricos atendiendo al origen y trayectoria de las masas de aire en el Norte de Espa&#241;a"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0015"
          "etiqueta" => "Fig&#46; 3"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr3.jpeg"
              "Alto" => 1046
              "Ancho" => 1658
              "Tamanyo" => 109176
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Back-trajectories&#58; types and origin&#46; AFR&#58; North Africa and Mediterranean region of the peninsula&#59; EU&#58; French Cantabrian region&#59; N&#58; British Isles&#59; NW&#58; north Atlantic&#59; RECIRC&#58; recirculation&#59; SW&#58; Portuguese South-Atlantic&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Ana Santurt&#250;n, Domingo F&#46; Rasilla, Leyre Riancho-Zarrabeitia, Mar&#237;a T&#46; Zarrabeitia"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Ana"
              "apellidos" => "Santurt&#250;n"
            ]
            1 => array:2 [
              "nombre" => "Domingo F&#46;"
              "apellidos" => "Rasilla"
            ]
            2 => array:2 [
              "nombre" => "Leyre"
              "apellidos" => "Riancho-Zarrabeitia"
            ]
            3 => array:2 [
              "nombre" => "Mar&#237;a T&#46;"
              "apellidos" => "Zarrabeitia"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0300289617300832"
        "doi" => "10.1016/j.arbres.2017.03.017"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289617300832?idApp=UINPBA00003Z"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212917303075?idApp=UINPBA00003Z"
    "url" => "/15792129/0000005300000011/v2_201711201359/S1579212917303075/v2_201711201359/en/main.assets"
  ]
  "en" => array:20 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Special article</span>"
    "titulo" => "Using PICO Methodology to Answer Questions About Smoking in COPD Patients"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "622"
        "paginaFinal" => "628"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Carlos A&#46; Jim&#233;nez Ruiz, Daniel Buljubasich, Juan Antonio Riesco Miranda, Agust&#237;n Acu&#241;a Izcaray, Jos&#233; Ignacio de Granda Orive, Jos&#233; Miguel Chatkin, Gustavo Zabert, Alfredo Guerreros Benavides, Nelson Paez Espinel, Valeri No&#233;, Efra&#237;n S&#225;nchez-Angarita, Ingrid N&#250;&#241;ez-S&#225;nchez, Ra&#250;l H&#46; Sansores, Alejandro Casas, Andr&#233;s Palomar Lever, Inmaculada Alfageme Michavila"
        "autores" => array:16 [
          0 => array:4 [
            "nombre" => "Carlos A&#46;"
            "apellidos" => "Jim&#233;nez Ruiz"
            "email" => array:1 [
              0 => "victorina&#64;ctv&#46;es"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Daniel"
            "apellidos" => "Buljubasich"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Juan Antonio"
            "apellidos" => "Riesco Miranda"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Agust&#237;n"
            "apellidos" => "Acu&#241;a Izcaray"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">d</span>"
                "identificador" => "aff0020"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "Jos&#233; Ignacio"
            "apellidos" => "de Granda Orive"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">e</span>"
                "identificador" => "aff0025"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "Jos&#233; Miguel"
            "apellidos" => "Chatkin"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">f</span>"
                "identificador" => "aff0030"
              ]
            ]
          ]
          6 => array:3 [
            "nombre" => "Gustavo"
            "apellidos" => "Zabert"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">g</span>"
                "identificador" => "aff0035"
              ]
            ]
          ]
          7 => array:3 [
            "nombre" => "Alfredo"
            "apellidos" => "Guerreros Benavides"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">h</span>"
                "identificador" => "aff0040"
              ]
            ]
          ]
          8 => array:3 [
            "nombre" => "Nelson"
            "apellidos" => "Paez Espinel"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">i</span>"
                "identificador" => "aff0045"
              ]
            ]
          ]
          9 => array:3 [
            "nombre" => "Valeri"
            "apellidos" => "No&#233;"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">j</span>"
                "identificador" => "aff0050"
              ]
            ]
          ]
          10 => array:3 [
            "nombre" => "Efra&#237;n"
            "apellidos" => "S&#225;nchez-Angarita"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">k</span>"
                "identificador" => "aff0055"
              ]
            ]
          ]
          11 => array:3 [
            "nombre" => "Ingrid"
            "apellidos" => "N&#250;&#241;ez-S&#225;nchez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">l</span>"
                "identificador" => "aff0060"
              ]
            ]
          ]
          12 => array:3 [
            "nombre" => "Ra&#250;l H&#46;"
            "apellidos" => "Sansores"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">j</span>"
                "identificador" => "aff0050"
              ]
            ]
          ]
          13 => array:3 [
            "nombre" => "Alejandro"
            "apellidos" => "Casas"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">m</span>"
                "identificador" => "aff0065"
              ]
            ]
          ]
          14 => array:3 [
            "nombre" => "Andr&#233;s"
            "apellidos" => "Palomar Lever"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">n</span>"
                "identificador" => "aff0070"
              ]
            ]
          ]
          15 => array:3 [
            "nombre" => "Inmaculada"
            "apellidos" => "Alfageme Michavila"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">o</span>"
                "identificador" => "aff0075"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:15 [
          0 => array:3 [
            "entidad" => "Unidad Especializada en Tabaquismo&#44; PII Tabaquismo SEPAR&#44; Madrid&#44; Spain"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Servicio de Neumolog&#237;a&#44; Hospital Espa&#241;ol&#44; Grupo Tabaquismo ALAT Rosario&#44; Argentina"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Servicio de Neumolog&#237;a&#44; Hospital San Pedro de Alc&#225;ntara&#44; C&#225;ceres&#44; Spain"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
          3 => array:3 [
            "entidad" => "Hospital Universitario de Caracas&#44; Universidad Central de Venezuela&#44; Centro M&#233;dico Docente La Trinidad&#44; Caracas&#44; Venezuela"
            "etiqueta" => "d"
            "identificador" => "aff0020"
          ]
          4 => array:3 [
            "entidad" => "Servicio de Neumolog&#237;a&#44; Hospital Universitario 12 de Octubre&#44; &#193;rea de Tabaquismo SEPAR&#44; Madrid&#44; Spain"
            "etiqueta" => "e"
            "identificador" => "aff0025"
          ]
          5 => array:3 [
            "entidad" => "Medicina Interna&#44; Faculdade de Medicina&#44; Pontificia Universidade Cat&#243;lica do Rio Grande do Sul&#44; Porto Alegre&#44; Brazil"
            "etiqueta" => "f"
            "identificador" => "aff0030"
          ]
          6 => array:3 [
            "entidad" => "Asociaci&#243;n Latinoamericana del T&#243;rax&#44; Facultad de Ciencias M&#233;dicas&#44; Universidad Nacional del Comahue&#44; Neuqu&#233;n&#44; Argentina"
            "etiqueta" => "g"
            "identificador" => "aff0035"
          ]
          7 => array:3 [
            "entidad" => "Facultad de Medicina San Fernando&#44; Universidad Nacional Mayor de San Marcos&#44; Sociedad Peruana de Neumolog&#237;a&#44; Lima&#44; Peru"
            "etiqueta" => "h"
            "identificador" => "aff0040"
          ]
          8 => array:3 [
            "entidad" => "Fundaci&#243;n Neumol&#243;gica Colombiana&#44; Programa de cesaci&#243;n de Tabaquismo &#8220;Exfumaire&#8221;&#44; Universidad de La Sabana&#44; Ch&#237;a&#44; Colombia"
            "etiqueta" => "i"
            "identificador" => "aff0045"
          ]
          9 => array:3 [
            "entidad" => "Departamento de Investigaci&#243;n en Tabaquismo y EPOC&#44; Instituto Nacional de Enfermedades Respiratorias&#44; Ciudad de M&#233;xico&#44; Mexico"
            "etiqueta" => "j"
            "identificador" => "aff0050"
          ]
          10 => array:3 [
            "entidad" => "Servicio de Neumolog&#237;a&#44; Hospital Universitario de Caracas&#44; Universidad Central de Venezuela&#44; Centro M&#233;dico docente La Trinidad&#44; Caracas&#44; Venezuela"
            "etiqueta" => "k"
            "identificador" => "aff0055"
          ]
          11 => array:3 [
            "entidad" => "Servicio de Neumolog&#237;a y Cirug&#237;a de T&#243;rax&#44; Hospital Universitario de Caracas&#44; Universidad Central de Venezuela&#44; Caracas&#44; Venezuela"
            "etiqueta" => "l"
            "identificador" => "aff0060"
          ]
          12 => array:3 [
            "entidad" => "Universidad del Rosario&#44; Fundaci&#243;n Neumol&#243;gica Colombiana&#44; Bogot&#225;&#44; Colombia"
            "etiqueta" => "m"
            "identificador" => "aff0065"
          ]
          13 => array:3 [
            "entidad" => "Centro m&#233;dico ABC de la Ciudad de M&#233;xico&#44; Escuela de Medicina del TEC de Monterrey Campus ABC de la Ciudad M&#233;xico&#44; Ciudad de M&#233;xico&#44; Mexico"
            "etiqueta" => "n"
            "identificador" => "aff0070"
          ]
          14 => array:3 [
            "entidad" => "Hospital Universitario Virgen de Valme&#44; Universidad de Sevilla&#44; SEPAR&#44; Sevilla&#44; Spain"
            "etiqueta" => "o"
            "identificador" => "aff0075"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Preguntas y respuestas relacionadas con tabaquismo en pacientes con EPOC&#46; Aplicaci&#243;n de metodolog&#237;a con formato PICO"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Approximately 85&#37; of chronic obstructive pulmonary disease &#40;COPD&#41; is caused by tobacco consumption&#46; Smoking cessation is the only measure that has been shown to be effective for halting the progression of the disease&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">1</span></a> Various papers have analyzed the characteristics of health interventions for smoking cessation in smokers with COPD&#46;<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">2&#8211;6</span></a> In all of these&#44; some outstanding questions remain to be answered using scientific methodology&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">The Treatment and Control of Smoking Groups of the Latin-American Thoracic Association &#40;ALAT&#41; and the Spanish Society of Pulmonology and Thoracic Surgery &#40;SEPAR&#41; have collaborated in the preparation of this document which uses PICO methodology to answer questions on smoking cessation treatment in COPD patients&#46; The main objective of this document is to provide healthcare professionals with up-to-date scientific information in this area&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Methodology</span><p id="par0015" class="elsevierStylePara elsevierViewall">A collaborative group was formed and clinical questions were formulated&#46; Four working subgroups were constituted&#44; formed of members of the two medical associations involved&#44; ALAT and SEPAR&#46; These subgroups drew up a list of clinical questions and selected by consensus those that should be addressed in these recommendations&#46; In order to focus the search for available evidence&#44; all clinical questions were transformed to the PICO format or the PECO variant&#58; Patient &#40;problem or population&#41;&#44; Intervention or Exposure&#44; Comparison&#44; and Outcome&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">7</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">The literature search strategy was conducted simultaneously in 2 metasearch engines&#44; the Trip database and PubMed&#44; using MeSH &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Eligibility Criteria</span><p id="par0025" class="elsevierStylePara elsevierViewall">The results retrieved for PICO questions were prioritized according to the highest level of evidence &#40;randomized controlled trials &#91;RCTs&#93;&#44; meta-analyses and systematic reviews&#41; and the most appropriate answer to the clinical question&#46; If this was not possible&#44; intermediate &#40;observational&#41; or low level &#40;open-label&#44; case series or consensus&#41; studies in the hierarchy of evidence were selected&#46; The recommended algorithmic selection method was used primarily for therapeutic questions&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">8</span></a> Studies published in Spanish&#44; Portuguese and English were considered for inclusion&#46; The end date of the search was May 2016 &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Critical Analysis and Formulation of Recommendations</span><p id="par0030" class="elsevierStylePara elsevierViewall">Recommendations and templates developed by the CASPE network &#40;<a href="http://www.redcaspe.org/">www&#46;redcaspe&#46;org</a>&#41; were used for the critical appraisal of the selected references&#46; The ACCP grading system was used to classify recommendations as strong<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">1</span></a> or weak&#44;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">2</span></a> according to the balance of risk&#44; benefits&#44; burdens&#44; and&#44; in some cases&#44; cost&#46; The quality of evidence was classified as high &#40;A&#41;&#44; moderate &#40;B&#41; or low &#40;C&#41;&#44; depending on the study design&#44; consistency of results&#44; and ability of the evidence to clearly answer the PICO question&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">9</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">The authors appointed two external reviewers with expertise in the field of COPD and smoking&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">PICO Question</span><p id="par0040" class="elsevierStylePara elsevierViewall">Does spirometry motivate the smoker with COPD to stop smoking&#63;</p><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Rationale</span><p id="par0045" class="elsevierStylePara elsevierViewall">Significant efforts have been made to increase the rate of smoking cessation using motivational tools and measures&#44; such as spirometry measurements&#44; co-oximetry&#44; and the calculation of lung age&#46; It is of interest to determine the status of current clinical research aimed at answering this question&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Search Results</span><p id="par0050" class="elsevierStylePara elsevierViewall">Thirty-one references were retrieved &#40;MeSH&#58; 5&#59; Trip database&#58; 26&#41;&#44; and 7 studies were selected to answer the question &#40;2 systematic reviews&#44; 4 randomized clinical trials &#91;RCT&#93;&#44; and 1 cohort study&#41;&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Quality of Evidence</span><p id="par0055" class="elsevierStylePara elsevierViewall">One systematic review found limited benefits from the use of spirometry as a motivating factor for increasing smoking cessation&#44;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">10</span></a> and another<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">11</span></a> evaluated the effectiveness of the use of biomedical instruments for increasing motivation in smoking cessation&#46; Both included 15 RCTs&#44; 2 of which used spirometry in primary care as a motivator&#46; No statistically significant benefit was identified in the smoking cessation rate when spirometry was used&#46; The analysis does not evaluate the motivating effect of the spirometry test when the result was abnormal&#46; In this respect&#44; a more recent RCT<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">12</span></a> showed that bronchial obstruction was the most significant predictor of smoking cessation &#40;OR&#58; 4&#46;215&#59; 95&#37; CI&#58; 2&#46;215&#8211;7&#46;865&#41;&#46; Similarly&#44; in another study&#44;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">13</span></a> 4494 smokers selected from 100<span class="elsevierStyleHsp" style=""></span>000 subjects with obstructive spirometry were informed in a phone call about COPD and given brief smoking cessation counseling&#46; The results showed a cessation rate of 16&#46;3&#37; among patients with obstruction compared to 12&#37; among those with normal spirometry &#40;<span class="elsevierStyleItalic">P</span>&#61;&#46;0003&#41;&#46; An RCT<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">14</span></a> which compared COPD patients to smokers with normal spirometry&#44; and included a 3-year follow-up and pharmacological interventions&#44; found a higher rate of cessation among smokers with COPD at the 3-year follow-up &#40;29&#37; versus 14&#37;&#59; <span class="elsevierStyleItalic">P</span>&#61;&#46;003&#41;&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">As for the motivating effect of explaining to the patient their lung age calculated according to spirometry&#44; an RCT<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">15</span></a> found a smoking cessation rate at 12 months of 13&#46;6&#37; compared to 6&#46;4&#37; in the control group &#40;<span class="elsevierStyleItalic">P</span>&#61;&#46;05&#59; NNT&#61;14&#41;&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">An RCT<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">16</span></a> failed to show efficacy when smokers with no previous diagnosis of COPD were confronted with spirometry results&#44; even though the cessation rate was twice that of the control group &#40;OR&#58; 2&#46;02&#59; 95&#37; CI&#58; 0&#46;63&#8211;6&#46;46&#41;&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Conclusions and Recommendations</span><p id="par0070" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Moderate</span> evidence that spirometry results encourage smoking cessation in patients with COPD or in at-risk smokers&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Strong</span> recommendation to perform spirometry in patients with a diagnosis or in symptomatic smokers as a motivational tool and for diagnostic purposes in active case-finding&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Grade of recommendation&#58; 1B&#46;</p></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">PICO Question</span><p id="par0085" class="elsevierStylePara elsevierViewall">Is the treatment of smoking different between smokers with and without COPD&#63;</p><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Rationale</span><p id="par0090" class="elsevierStylePara elsevierViewall">The conclusions from studies analyzing the treatment of smoking among smokers with COPD suggest that the combination of psychological counseling and pharmacological treatment is most effective&#46;<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">2&#44;17&#8211;19</span></a></p><p id="par0095" class="elsevierStylePara elsevierViewall">It seems clear that when the intensity of psychological counseling is mild&#44; efficacy in this group of smokers is very limited or non-existent&#46; In smokers with COPD&#44; psychological counseling should be intense both in terms of number of sessions and time dedicated to each session&#46; Counseling must be offered with empathy&#44; respect and understanding for the patient&#46; The intimate relationship between the consumption of tobacco and COPD should be clearly explained to the patient&#44; and they must be shown that the only treatment that has been identified as capable of controlling the chronic evolution of the disease is to stop smoking&#46; Similarly&#44; it must emphasized that in COPD&#44; giving up smoking contributes definitively to the control of the four major symptoms of COPD&#58; cough&#44; expectoration&#44; dyspnea&#44; and chest tightness&#46;<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">2&#44;17&#8211;19</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">Three types of drugs have been used in clinical studies&#58; nicotine replacement therapy &#40;NRT&#41;&#44; varenicline and bupropion&#46; All these studies have shown that the association between active drug and psychological counseling is more effective than the association between counseling and placebo&#46; NRT and varenicline have been shown to be effective at 6 and 12 months of follow-up&#44; whereas bupropion was effective at 6 months only&#46;<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">2&#44;17&#8211;19</span></a></p><p id="par0105" class="elsevierStylePara elsevierViewall">A study has found that the efficacy rates in these patients are higher when pharmacological treatment is offered in addition to counseling &#40;for more than 3 months&#44; or in a combination of several drugs&#44; or at high doses&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">3&#44;4</span></a></p><p id="par0110" class="elsevierStylePara elsevierViewall">It is important to determine which components are indispensable in the counseling of smokers&#44; in order to make it more effective&#46; It is also important to determine how to provide the most effective pharmacological treatment&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Search Selection</span><p id="par0115" class="elsevierStylePara elsevierViewall">Thirty-one references were retrieved &#40;MeSH&#58; 5&#59; Trip database&#58; 22&#41;&#44; and 8 studies were selected to answer the question &#40;3 systematic reviews&#44; 2 meta-analyses&#44; 2 RCTs&#44; and 1 cross-sectional study&#41;&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Summary of Evidence</span><p id="par0120" class="elsevierStylePara elsevierViewall">One of the first reviews on smoking cessation in smokers with COPD showed that the combination of behavioral counseling and pharmacological treatment was superior to no treatment &#40;RR&#58; 4&#46;0&#59; 95&#37; CI&#58; 3&#46;25&#8211;4&#46;93&#41; or the use of behavioral counseling only &#40;RR&#58; 4&#46;19&#59; 95&#37; CI&#58; 3&#46;41&#8211;5&#46;15&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">17</span></a></p><p id="par0125" class="elsevierStylePara elsevierViewall">Another meta-analysis evaluated 7332 patients with COPD who received different treatments for smoking cessation&#44; and found that the combination of behavioral counseling plus NRT was the most effective type of intervention &#40;OR&#58; 5&#46;08&#59; <span class="elsevierStyleItalic">P</span>&#60;&#46;0001&#41; compared to behavioral counseling only &#40;OR&#58; 2&#46;8&#59; <span class="elsevierStyleItalic">P</span>&#61;&#46;001&#41; and compared to behavioral counseling in combination with an antidepressant &#40;OR&#58; 3&#46;32&#59; <span class="elsevierStyleItalic">P</span>&#61;&#46;002&#41;&#46; Behavioral counseling only came close to achieving efficacy when compared with standard care &#40;OR&#58; 1&#46;81&#59; <span class="elsevierStyleItalic">P</span>&#61;&#46;07&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">20</span></a></p><p id="par0130" class="elsevierStylePara elsevierViewall">Another study evaluated the effectiveness of high-intensity smoking treatment in smokers with COPD compared with standard care&#46; The high-intensity program consisted of a combination of pharmacological treatment plus hospitalization for 2 weeks and the administration of intensive behavioral counseling&#59; telephone contacts and continuous monitoring were also programmed for a period of 1&#8211;3 years&#46; Abstinence figures in the group that received the intensive treatment were 52&#37; and 38&#37; at 1 and 3 years of follow-up&#44; respectively&#44; vs 7&#37; and 10&#37;&#44; respectively&#44; in the group that received standard care&#46;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">21</span></a></p><p id="par0135" class="elsevierStylePara elsevierViewall">One of studies that has shed most light on the issue is probably that of Hoogendoon et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">18</span></a> who conducted a systematic review of various clinical trials in patients with COPD&#46; The different interventions were grouped into 4 categories&#58; standard care&#44; minimal intervention&#44; intensive behavioral counseling&#44; and intensive behavioral counseling plus pharmacological treatment&#46; The abstinence rates after 1 year of follow-up for each of the categories were&#58; 1&#46;4&#37;&#44; 2&#46;6&#37;&#44; 6&#37; and 12&#46;3&#37;&#44; respectively&#46; Compared to standard treatment&#44; the cost per quality-adjusted life year &#40;QALY&#41; gained for the minimum intervention was 16<span class="elsevierStyleHsp" style=""></span>900 euros&#44; 8200 euros for intensive behavioral counseling&#44; and 2400 euros for intensive behavioral counseling plus pharmacological treatment&#46; The authors conclude that the combination of intensive behavioral counseling plus pharmacological treatment is the most successful and cost-effective treatment of smoking in COPD patients&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Bartlett et al&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">22</span></a> evaluated 17 randomized trials to determine what type of behavioral counseling for smoking cessation is most effective in smokers with COPD&#46; This study identified 5 counseling techniques that are significantly associated with the best results&#58; &#40;1&#41; action planning&#59; &#40;2&#41; recording course of symptoms&#44; achievements&#44; and failures&#59; &#40;3&#41; weight control&#59; &#40;4&#41; social support&#59; and &#40;5&#41; explaining clearly explain the relationship between COPD and smoking&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Two clinical trials have examined the efficacy and safety of bupropion&#46; One found that bupropion was more effective than placebo in achieving continuous abstinence at 6 months of follow-up &#40;16&#37; vs 9&#37;&#59; <span class="elsevierStyleItalic">P</span>&#60;&#46;05&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">23</span></a> The other also showed similar results at 6 months of follow-up &#40;difference of 18&#46;9&#37; &#91;95&#37; CI&#58; 3&#46;6&#8211;34&#46;2&#93;&#59; <span class="elsevierStyleItalic">P</span>&#61;&#46;02&#46;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">24</span></a></p><p id="par0150" class="elsevierStylePara elsevierViewall">The efficacy and safety of varenicline was analyzed in an RCT which found that varenicline was more effective than placebo for helping smokers to quit at 3&#44; 6 and 12 months of follow-up&#46; At the end of the year&#44; the figures were 18&#46;6&#37; vs 5&#46;6&#37; &#40;OR&#58; 4&#46;04 &#91;95&#37; CI&#58; 2&#46;13&#8211;7&#46;67&#93;&#59; <span class="elsevierStyleItalic">P</span>&#60;&#46;0001&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">25</span></a></p><p id="par0155" class="elsevierStylePara elsevierViewall">A recent review analyzing 16 studies that included more than 13<span class="elsevierStyleHsp" style=""></span>000 patients has reached similar conclusions to those discussed here&#46;<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">26</span></a></p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conclusions and Recommendations</span><p id="par0160" class="elsevierStylePara elsevierViewall">The available evidence indicates that the most effective intervention to help subjects with COPD to quit smoking is a combination of intensive behavioral counseling plus pharmacological treatment&#46; This intervention is highly cost-effective&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">Behavioral counseling should be intensive and prolonged&#59; the greater the intensity and the longer the duration&#44; the greater the efficacy&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">A choice of NRT&#44; bupropion or varenicline can be used as pharmacological treatment&#46; Bupropion showed efficacy only at 6 months of follow-up&#46; NRT and varenicline have been shown to be effective at 6 and 12 months of follow-up&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">High</span> evidence and <span class="elsevierStyleItalic">strong</span> recommendation for intensive behavioral counseling plus pharmacological treatment &#40;NRT and varenicline are superior to bupropion&#41; to help smokers with COPD to quit&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">Grade of recommendation&#58; 1A&#46;</p></span></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">PICO Question</span><p id="par0185" class="elsevierStylePara elsevierViewall">Is smoking cessation intervention effective in hospitalized smokers with COPD&#63;</p><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Rationale</span><p id="par0190" class="elsevierStylePara elsevierViewall">Around 25&#37;&#8211;35&#37; of COPD patients admitted to hospital are smokers&#46; Hospitalization is an ideal situation to help smokers quit&#46; Taking into account these premises&#44; hospitalization of an individual with COPD represents an important opportunity to determine their smoking status and to intervene decisively&#46;<a class="elsevierStyleCrossRefs" href="#bib0325"><span class="elsevierStyleSup">27&#44;28</span></a></p></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Search Selection</span><p id="par0195" class="elsevierStylePara elsevierViewall">Seven references were retrieved &#40;MeSH&#58; 3&#59; Trip database&#58; 1&#59; and by snow-balling&#58; 3&#41;&#44; and 6 studies were selected to answer the question &#40;3 RCTs&#44; 1 systematic review&#44; 1 economic evaluation&#44; and 1 cohort study&#41;&#46;</p></span><span id="sec0090" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Summary of Evidence</span><p id="par0200" class="elsevierStylePara elsevierViewall">A systematic review found that intensive behavioral interventions that begin in the hospital and continue for at least 1 month after discharge increase abstinence rates &#40;RR&#58; 1&#46;37&#59; 95&#37; CI&#58; 1&#46;27&#8211;1&#46;48&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">29</span></a> One study found that the combination of intensive intervention plus NRT increased abstinence rates compared with intensive intervention alone &#40;RR&#58; 1&#46;54&#59; 95&#37; CI&#58; 1&#46;34&#8211;1&#46;79&#41;&#46; However&#44; 2 other studies failed to show that adding varenicline or bupropion increases abstinence rates&#46; Similar results were found in a subgroup of smokers who were admitted for cardiovascular diseases&#59; in this subgroup&#44; intensive intervention followed by subsequent support increased abstinence rates &#40;RR&#58; 1&#46;42&#59; 95&#37; CI&#58; 1&#46;29&#8211;1&#46;56&#41; when compared with non-intensive intervention&#46;</p><p id="par0205" class="elsevierStylePara elsevierViewall">Abstinence rates were compared in 2 groups of smokers enrolled in a clinical trial&#46;<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">30</span></a> One group received intensive intervention &#40;free pharmacological treatment for 90 days&#44; regular phone calls and behavioral reinforcement&#41;&#44; while the control group only received recommendations on the use of the medication at the time of discharge&#46; Point prevalence abstinence at 6 months was significantly higher in the intervention group &#40;26&#37; vs 15&#37;&#59; RR&#58; 1&#46;71&#59; 95&#37; CI&#58; 1&#46;14&#8211;2&#46;56&#59; <span class="elsevierStyleItalic">P</span>&#61;&#46;009&#59; NNT&#58; 9&#46;4&#59; 95&#37; CI&#58; 6&#46;4&#8211;35&#46;5&#41;&#46; The same was observed for continuous abstinence rates at 6 months &#40;27&#37; vs 16&#37;&#59; RR&#58; 1&#46;70&#59; 95&#37; CI&#58; 1&#46;15&#8211;2&#46;51&#41;&#46;</p><p id="par0210" class="elsevierStylePara elsevierViewall">A pharmacoeconomic study analyzed the cost-effectiveness of the Ottawa model for smoking cessation &#40;OMSC&#41; in patients hospitalized for various diseases&#44; including COPD&#46;<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">31</span></a> The OMSC includes psychological counseling and pharmacological treatment&#46; The authors found that the OMSC program was very cost-effective with a 1-year cost per QALY gained of C&#36;1386&#44; and lifetime cost per QALY gained of C&#36;68&#46; The study showed that using the Ottawa model in 15<span class="elsevierStyleHsp" style=""></span>326 hospitalized smokers in 1 year would achieve a total of 4689 quitters&#44; and would prevent 116 re-hospitalizations&#44; 923 hospital days&#44; and 119 deaths in all of these chronic diseases&#46;</p><p id="par0215" class="elsevierStylePara elsevierViewall">A clinical trial carried out by Borglykke et al&#46;<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">32</span></a> compared the rates of abstinence in 2 groups of smokers with COPD attending the emergency department of a hospital&#46; One group was randomized to receive intensive intervention and the other was the control group&#46; Patients were followed up at 1 year and 3 years after the intervention&#46; The results showed that at the 1-year follow-up&#44; the abstinence rate in the intervention group was significantly higher than in the control group &#40;30&#37; vs 13&#37;&#59; OR&#58; 2&#46;83&#59; 95&#37; CI&#58; 1&#46;40&#8211;5&#46;74&#41;&#46; Moreover&#44; no significant differences were found in terms of the amount of phlegm or survival &#40;50&#46;4&#37; vs 43&#46;1&#37;&#59; HR&#58; 0&#46;80&#59; 95&#37; CI&#58; 0&#46;55&#8211;1&#46;16&#41;&#46; However&#44; at the 3-year follow-up&#44; the intervention group had been hospitalized significantly fewer days for COPD or other causes&#46;</p><p id="par0220" class="elsevierStylePara elsevierViewall">A clinical trial<a class="elsevierStyleCrossRef" href="#bib0355"><span class="elsevierStyleSup">33</span></a> randomized 172 patients to 2 groups&#46; The intervention group received medical counseling for quitting smoking and screening for gastroesophageal reflux&#44; depression and&#47;or anxiety&#44; in addition to education on the use of inhalers&#46; Compared with the control group&#44; the results showed no significant differences in readmissions or consultations within 30 days after discharge&#44; or in the rate of readmissions at 90 days&#46;</p><p id="par0225" class="elsevierStylePara elsevierViewall">Another study in a cohort of COPD patients hospitalized for exacerbations<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">34</span></a> reviewed the effectiveness of a brief anti-smoking counseling session during admission and the use of medication to assist smoking cessation after discharge&#46; A total of 1334 patients were included&#58; 19&#46;8&#37; reported having stopped smoking at 6 and 12 months of follow-up&#44; 17&#46;5&#37; had no reported status&#44; and 63&#46;7&#37; continued smoking&#46; It is interesting to note that only 33&#46;7&#37; of the patients used smoking cessation medication&#46; The results did not show higher rates of abstinence among those who received medication to quit smoking&#46; Nor was any association found between anti-smoking counseling at the time of discharge and abstinence&#44; or between those who received medication in the 48-h period after discharge or in those who had received treatment in the year prior to admission&#46; Patients who received varenicline presented significantly higher rates of abstinence &#40;OR&#58; 2&#46;44&#59; 95&#37; CI&#58; 1&#46;48&#8211;4&#46;05&#41;&#44; while those who received NRT in monotherapy showed the worst results &#40;OR&#58; 0&#46;66&#59; 95&#37; CI&#58; 0&#46;51&#8211;0&#46;85&#41;&#46; Patients treated with bupropion or combination therapy were no more likely to report cessation&#46;</p></span><span id="sec0095" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Conclusions and Recommendations</span><p id="par0230" class="elsevierStylePara elsevierViewall">The available evidence indicates that intensive intervention to help quit smoking initiated while the patient is hospitalized plus at least 1 month of follow-up after hospital discharge achieves higher abstinence rates when compared with smokers who received standard treatment&#46; Effectiveness increases significantly when psychological counseling is added to treatment with NRT or varenicline&#46; This intervention is highly cost-effective&#46;</p><p id="par0235" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">High</span> evidence and <span class="elsevierStyleItalic">strong</span> recommendation for initiating interventions to help COPD patients stop smoking during hospitalization&#46;</p><p id="par0240" class="elsevierStylePara elsevierViewall">Grade of recommendation&#58; 1A&#46;</p></span></span><span id="sec0100" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">PICO Question</span><p id="par0245" class="elsevierStylePara elsevierViewall">Would funding the treatment of smoking in smokers with COPD impact on health economics&#63;</p><span id="sec0105" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Rationale</span><p id="par0250" class="elsevierStylePara elsevierViewall">COPD places a considerable economic burden on public health systems&#46; In Spain&#44; costs amount to &#8364;3bn&#46; a year&#46; It is also known that the cost of care incurred by a smoker with COPD is approximately &#8364;3700&#47;year&#44; while individuals with COPD who have stopped smoking incur costs of &#8364;2000&#47;year&#46; Accordingly&#44; then&#44; when a smoker with COPD quits&#44; savings to the National Health System amount to around &#8364;1300&#47;year&#46;<a class="elsevierStyleCrossRef" href="#bib0365"><span class="elsevierStyleSup">35</span></a></p></span><span id="sec0110" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Search Selection</span><p id="par0255" class="elsevierStylePara elsevierViewall">Twenty-two references were retrieved &#40;MeSH&#58; 17&#59; Trip database&#58; 5&#41;&#44; and 4 studies were selected to answer the question &#40;3 cohort studies and 1 case&#8211;control&#41;&#46;</p></span><span id="sec0115" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Summary of Evidence</span><p id="par0260" class="elsevierStylePara elsevierViewall">A case&#8211;control study conducted in Spain&#44; in which costs generated by smokers with COPD were compared with those of former smokers with COPD over a 12-month period&#44; found that the smokers with COPD consumed more health care resources compared to former smokers&#44; regardless of their COPD severity stage&#46;<a class="elsevierStyleCrossRef" href="#bib0365"><span class="elsevierStyleSup">35</span></a></p><p id="par0265" class="elsevierStylePara elsevierViewall">Three simulated cohort studies in the United Kingdom&#44; Spain and France have analyzed the scenario of funding smoking cessation in patients with COPD using a Markov model&#58; &#40;1&#41; in COPD patients in the United Kingdom&#44;<a class="elsevierStyleCrossRef" href="#bib0370"><span class="elsevierStyleSup">36</span></a> the ICER &#40;incremental cost-effectiveness ratio&#41; was &#163;2686 per QALY and continued to yield savings after 10 years in all patients&#44; regardless of COPD severity and percentage of success of the intervention applied&#59; &#40;2&#41; in Spain&#44;<a class="elsevierStyleCrossRef" href="#bib0375"><span class="elsevierStyleSup">37</span></a> the model was developed with a time horizon of 5 years and considered the 3 approved first-line drugs &#40;varenicline&#44; bupropion and NRT&#41;&#46; Estimates were that 17<span class="elsevierStyleHsp" style=""></span>756 COPD patients would give up smoking if the treatment were funded&#44; compared to 1303 patients if it was not&#46;<a class="elsevierStyleCrossRef" href="#bib0380"><span class="elsevierStyleSup">38</span></a> In the reimbursement scenario&#44; accumulated savings would be &#8364;4&#46;3 million&#59; &#40;3&#41; in France&#44; a cost-effectiveness study in patients with COPD&#44; cancer&#44; and cardiovascular disease allowed the authors to conclude that for a 5-year horizon&#44; cost savings would be made in the range of &#8364;15&#8211;215 million with an ICER of &#8364;11<span class="elsevierStyleHsp" style=""></span>187 per QALY&#46;</p></span><span id="sec0120" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Conclusions and Recommendations</span><p id="par0270" class="elsevierStylePara elsevierViewall">Studies analyzing the impact of funding of smoking cessation in patients with COPD make the following conclusions&#58; &#40;a&#41; COPD patients who continue to smoke use more health care resources and generate greater social and economic costs&#59; and &#40;b&#41; the funding of smoking cessation in smokers with COPD is highly effective and cost-effective&#46;</p><p id="par0275" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Moderate</span> evidence and <span class="elsevierStyleItalic">strong</span> recommendation for the funding of the treatment of smoking in smokers with COPD&#44; due to the impact on health and health economics&#46;</p><p id="par0280" class="elsevierStylePara elsevierViewall">Grade of recommendation&#58; 1B&#46;</p></span></span><span id="sec0125" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Conflict of Interests</span><p id="par0285" class="elsevierStylePara elsevierViewall">Dr&#46; Carlos A&#46; Jim&#233;nez Ruiz has worked with GSK and Pfizer&#44; pharmaceutical companies with an interest in the field of the treatment of smoking&#46;</p><p id="par0290" class="elsevierStylePara elsevierViewall">Dr&#46; Daniel Buljubasich has no conflict of interest&#46;</p><p id="par0295" class="elsevierStylePara elsevierViewall">Dr&#46; Juan A&#46; Riesco Miranda has worked with GSK&#44; Pfizer&#44; Novartis&#44; Boehringer Ingelheim and Astra-Zeneca in training and clinical research activities&#46;</p><p id="par0300" class="elsevierStylePara elsevierViewall">Dr&#46; August&#237;n Acu&#241;a Izcaray has received fees for lectures and&#47;or scientific consultancy from Astra-Zeneca&#44; Novartis and Pfizer&#46;</p><p id="par0305" class="elsevierStylePara elsevierViewall">Dr&#46; Jos&#233; Ignacio de Granda Orive has no conflict of interest&#46;</p><p id="par0310" class="elsevierStylePara elsevierViewall">Dr&#46; Jos&#233; Miguel Chatkin has no conflict of interest&#46;</p><p id="par0315" class="elsevierStylePara elsevierViewall">Dr&#46; Gustavo Zabert received fees for educational activities from Global Bridges and the InterAmerican Heart Foundation and for speaking engagements from Astra-Zeneca&#44; Novartis&#44; Boehringer Ingelheim&#44; and Pfizer&#46;</p><p id="par0320" class="elsevierStylePara elsevierViewall">Dr&#46; Alfredo Guerreros Benavides has no conflict of interest&#46;</p><p id="par0325" class="elsevierStylePara elsevierViewall">Dr&#46; Nelson Paez Espinel has no conflict of interest&#46;</p><p id="par0330" class="elsevierStylePara elsevierViewall">Mrs&#46; Valeri Noah has no conflict of interest&#46;</p><p id="par0335" class="elsevierStylePara elsevierViewall">Dr&#46; Efra&#237;n S&#225;nchez-Angarita has received fees for lectures at conferences and educational activities related to COPD treatment from Novartis&#44; Boehringer Ingelheim&#44; Takeda&#44; and Pfizer&#46;</p><p id="par0340" class="elsevierStylePara elsevierViewall">Dr&#46; Ingrid N&#250;&#241;ez-S&#225;nchez has no conflict of interest&#46;</p><p id="par0345" class="elsevierStylePara elsevierViewall">Dr&#46; Dr&#46; Ra&#250;l H&#46; Sansores has no conflict of interest&#46;</p><p id="par0350" class="elsevierStylePara elsevierViewall">Dr&#46; Alejandro Casas has no conflict of interest&#46;</p><p id="par0355" class="elsevierStylePara elsevierViewall">Dr&#46; Andres Palomar Lever has received fees for speaking engagements from Novartis and Actelion&#46;</p><p id="par0360" class="elsevierStylePara elsevierViewall">Dr&#46; Inmaculada Alfageme Michavila has no conflict of interest&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:12 [
        0 => array:3 [
          "identificador" => "xres941033"
          "titulo" => "Abstract"
          "secciones" => array:1 [
            0 => array:1 [
              "identificador" => "abst0005"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec914255"
          "titulo" => "Keywords"
        ]
        2 => array:3 [
          "identificador" => "xres941032"
          "titulo" => "Resumen"
          "secciones" => array:1 [
            0 => array:1 [
              "identificador" => "abst0010"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec914256"
          "titulo" => "Palabras clave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:3 [
          "identificador" => "sec0010"
          "titulo" => "Methodology"
          "secciones" => array:2 [
            0 => array:2 [
              "identificador" => "sec0015"
              "titulo" => "Eligibility Criteria"
            ]
            1 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "Critical Analysis and Formulation of Recommendations"
            ]
          ]
        ]
        6 => array:3 [
          "identificador" => "sec0025"
          "titulo" => "PICO Question"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "sec0030"
              "titulo" => "Rationale"
            ]
            1 => array:2 [
              "identificador" => "sec0035"
              "titulo" => "Search Results"
            ]
            2 => array:2 [
              "identificador" => "sec0040"
              "titulo" => "Quality of Evidence"
            ]
            3 => array:2 [
              "identificador" => "sec0045"
              "titulo" => "Conclusions and Recommendations"
            ]
          ]
        ]
        7 => array:3 [
          "identificador" => "sec0050"
          "titulo" => "PICO Question"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "sec0055"
              "titulo" => "Rationale"
            ]
            1 => array:2 [
              "identificador" => "sec0060"
              "titulo" => "Search Selection"
            ]
            2 => array:2 [
              "identificador" => "sec0065"
              "titulo" => "Summary of Evidence"
            ]
            3 => array:2 [
              "identificador" => "sec0070"
              "titulo" => "Conclusions and Recommendations"
            ]
          ]
        ]
        8 => array:3 [
          "identificador" => "sec0075"
          "titulo" => "PICO Question"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "sec0080"
              "titulo" => "Rationale"
            ]
            1 => array:2 [
              "identificador" => "sec0085"
              "titulo" => "Search Selection"
            ]
            2 => array:2 [
              "identificador" => "sec0090"
              "titulo" => "Summary of Evidence"
            ]
            3 => array:2 [
              "identificador" => "sec0095"
              "titulo" => "Conclusions and Recommendations"
            ]
          ]
        ]
        9 => array:3 [
          "identificador" => "sec0100"
          "titulo" => "PICO Question"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "sec0105"
              "titulo" => "Rationale"
            ]
            1 => array:2 [
              "identificador" => "sec0110"
              "titulo" => "Search Selection"
            ]
            2 => array:2 [
              "identificador" => "sec0115"
              "titulo" => "Summary of Evidence"
            ]
            3 => array:2 [
              "identificador" => "sec0120"
              "titulo" => "Conclusions and Recommendations"
            ]
          ]
        ]
        10 => array:2 [
          "identificador" => "sec0125"
          "titulo" => "Conflict of Interests"
        ]
        11 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2016-12-06"
    "fechaAceptado" => "2017-04-09"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec914255"
          "palabras" => array:4 [
            0 => "Smoking"
            1 => "Chronic obstructive pulmonary disease"
            2 => "Treatment"
            3 => "Spirometry"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec914256"
          "palabras" => array:4 [
            0 => "Tabaquismo"
            1 => "Enfermedad pulmonar obstructiva cr&#243;nica"
            2 => "Tratamiento"
            3 => "Espirometr&#237;a"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The ALAT and SEPAR Treatment and Control of Smoking Groups have collaborated in the preparation of this document which attempts to answer&#44; by way of PICO methodology&#44; different questions on health interventions for helping COPD patients to stop smoking&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The main recommendations are&#58; &#40;i&#41; moderate-quality evidence and strong recommendation for performing spirometry in COPD patients and in smokers with a high risk of developing the disease&#44; as a motivational tool &#40;particularly for showing evidence of lung age&#41;&#44; a diagnostic tool&#44; and for active case-finding&#59; &#40;ii&#41; high-quality evidence and strong recommendation for using intensive dedicated behavioral counseling and drug treatment for helping COPD patients to stop smoking&#59; &#40;iii&#41; high-quality evidence and strong recommendation for initiating interventions for helping COPD patients to stop smoking during hospitalization with improvement when the intervention is prolonged after discharge&#44; and &#40;iv&#41; high-quality evidence and strong recommendation for funding treatment of smoking in COPD patients&#44; in view of the impact on health and health economics&#46;</p></span>"
      ]
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Los grupos de control y tratamiento del tabaquismo de ALAT y SEPAR han colaborado para la realizaci&#243;n de este documento en el que se da respuesta&#44; siguiendo metodolog&#237;a PICO&#44; a diferentes interrogantes relacionados con la asistencia sanitaria para ayudar a dejar de fumar a los pacientes con EPOC&#46;</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Sus principales recomendaciones son&#58; a&#41; evidencia moderada y recomendaci&#243;n fuerte para realizar espirometr&#237;a en pacientes con diagn&#243;stico o en fumadores con alto riesgo de padecer EPOC&#44; como instrumento de motivaci&#243;n&#44; en particular evidenciando la edad pulmonar&#44; y con fines diagn&#243;sticos y de b&#250;squeda activa de casos&#59; b&#41; evidencia alta y recomendaci&#243;n fuerte para utilizar asesoramiento conductual intenso y espec&#237;fico y tratamiento farmacol&#243;gico para ayudar a dejar de fumar a fumadores con EPOC&#59; c&#41; evidencia alta y recomendaci&#243;n fuerte para iniciar intervenciones para ayudar a dejar de fumar a fumadores con EPOC mientras se encuentran hospitalizados mejorando al mantener la intervenci&#243;n tras el alta&#44; y d&#41; evidencia alta y recomendaci&#243;n fuerte para la financiaci&#243;n del tratamiento del tabaquismo en fumadores con EPOC por su impacto sobre la salud y la econom&#237;a de la salud&#46;</p></span>"
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Please cite this article as&#58; Jim&#233;nez Ruiz CA&#44; Buljubasich D&#44; Riesco Miranda JA&#44; Acu&#241;a Izcaray A&#44; de Granda Orive JI&#44; Chatkin JM&#44; et al&#46; Preguntas y respuestas relacionadas con tabaquismo en pacientes con EPOC&#46; Aplicaci&#243;n de metodolog&#237;a con formato PICO&#46; Arch Bronconeumol&#46; 2017&#59;53&#58;622&#8211;628&#46;</p>"
      ]
    ]
    "multimedia" => array:2 [
      0 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Clinical Question&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">PICO Question&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Search Strategy Using MeSH Terms&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">Does spirometry motivate the smoker with COPD to stop smoking&#63;</td><td class="td" title="table-entry  " align="left" valign="top">&#40;a&#41;<br>P&#61;COPD or Chronic Obstructive Pulmonary Disease<br><span class="elsevierStyleSmallCaps">I</span>&#61;Smoking Cessation<br>C&#61;&#216;<br>O&#61;Lung age&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#40;&#40;&#40;&#40;&#8220;pulmonary disease&#44; chronic obstructive&#8221; &#91;MeSH Terms&#93; OR COPD OR Chronic Obstructive Pulmonary Disease OR COAD OR Chronic Obstructive Airway Disease OR Chronic Obstructive Lung Disease OR Airflow Obstruction&#44; Chronic OR Airflow Obstructions&#44; Chronic OR Chronic Airflow Obstructions OR Chronic Airflow Obstruction&#41;&#41;&#41; AND &#8220;Smoking Cessation&#8221; &#91;MeSH&#93;&#41; AND lung age&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">&#40;b&#41;<br>P&#61;COPD or Chronic Obstructive Pulmonary Disease<br><span class="elsevierStyleSmallCaps">I</span>&#61;Smoking Cessation<br>C&#61;&#216;<br>O&#61;&#40;&#8220;Spirometry&#8221; &#91;MeSH&#93; OR Spirometries&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#40;&#40;&#40;&#40;&#40;&#40;&#8220;pulmonary disease&#44; chronic obstructive&#8221; &#91;MeSH Terms&#93; OR COPD OR Chronic Obstructive Pulmonary Disease OR COAD OR Chronic Obstructive Airway Disease OR Chronic Obstructive Lung Disease OR Airflow Obstruction&#44; Chronic OR Airflow Obstructions&#44; Chronic OR Chronic Airflow Obstructions OR Chronic Airflow Obstruction&#41;&#41;&#41;&#41;&#41; AND &#40;&#40;cessation&#44; smoking OR cessations&#44; smoking OR smoking cessation&#41; OR &#8220;Smoking Cessation&#8221; &#91;MeSH&#93;&#41;&#41; AND &#40;&#8220;Spirometry&#8221; &#91;MeSH&#93; OR Spirometries&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">Is the treatment of smoking different between smokers with and without COPD&#63;</td><td class="td" title="table-entry  " align="left" valign="top">&#40;a&#41;<br>P&#61;COPD or Chronic Obstructive Pulmonary Disease<br><span class="elsevierStyleSmallCaps">I</span>&#61;Smoking Cessation<br>C&#61;&#216;<br>O&#61;&#216;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">&#40;&#40;&#40;&#40;&#40;&#8220;pulmonary disease&#44; chronic obstructive&#8221; &#91;MeSH Terms&#93; OR COPD OR Chronic Obstructive Pulmonary Disease OR COAD OR Chronic Obstructive Airway Disease OR Chronic Obstructive Lung Disease OR Airflow Obstruction&#44; Chronic OR Airflow Obstructions&#44; Chronic OR Chronic Airflow Obstructions OR Chronic Airflow Obstruction&#41;&#41;&#41;&#41;&#41; AND &#40;&#40;cessation&#44; smoking OR cessations&#44; smoking OR smoking cessation&#41; OR &#8220;Smoking Cessation&#8221; &#91;MeSH&#93;&#41; by relevance</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">&#40;b&#41;<br>P&#61;Smokers with COPD versus Smokers without COPD<br><span class="elsevierStyleSmallCaps">I</span>&#61;Smoking cessation treatment<br>C&#61;&#216;<br>O&#61;&#216;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">Is smoking cessation intervention effective in hospitalized smokers with COPD&#63;</td><td class="td" title="table-entry  " align="left" valign="top">&#40;a&#41;<br>P&#61;COPD or Chronic Obstructive Pulmonary Disease<br><span class="elsevierStyleSmallCaps">I</span>&#61;Smoking Cessation<br>C&#61;&#216;<br>O&#61;Hospitalization&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">&#40;&#40;&#40;&#40;&#40;&#40;&#40;&#8220;pulmonary disease&#44; chronic obstructive&#8221; &#91;MeSH Terms&#93; OR COPD OR Chronic Obstructive Pulmonary Disease OR COAD OR Chronic Obstructive Airway Disease OR Chronic Obstructive Lung Disease OR Airflow Obstruction&#44; Chronic OR Airflow Obstructions&#44; Chronic OR Chronic Airflow Obstructions OR Chronic Airflow Obstruction&#41;&#41;&#41;&#41;&#41; AND &#40;&#40;cessation&#44; smoking OR cessations&#44; smoking OR smoking cessation&#41; OR &#8220;Smoking Cessation&#8221; &#91;MeSH&#93;&#41;&#41;&#41; AND &#40;&#8220;Hospitalization&#8221; &#91;MeSH&#93; OR hospitalizations OR hospitalized&#41; Sort by&#58; Relevance</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">&#40;b&#41;<br>P&#61;COPD or Chronic Obstructive Pulmonary Disease<br><span class="elsevierStyleSmallCaps">I</span>&#61;Smoking Cessation<br>C&#61;&#216;<br>O&#61;Exacerbation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Would funding the treatment of smoking in smokers with COPD impact on health economics&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">P&#61;COPD or Chronic Obstructive Pulmonary Disease<br><span class="elsevierStyleSmallCaps">I</span>&#61;Smoking Cessation<br>C&#61;&#216;<br>O&#61;financing OR price OR pay OR incentives&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#40;&#40;&#40;&#40;&#40;&#40;&#8220;pulmonary disease&#44; chronic obstructive&#8221; &#91;MeSH Terms&#93; OR COPD OR Chronic Obstructive Pulmonary Disease OR COAD OR Chronic Obstructive Airway Disease OR Chronic Obstructive Lung Disease OR Airflow Obstruction&#44; Chronic OR Airflow Obstructions&#44; Chronic OR Chronic Airflow Obstructions OR Chronic Airflow Obstruction&#41;&#41;&#41;&#41;&#41; AND &#40;&#40;cessation&#44; smoking OR cessations&#44; smoking OR smoking cessation&#41; OR &#8220;Smoking Cessation&#8221; &#91;MeSH&#93;&#41;&#41; AND &#40;financing OR price OR pay OR incentives&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1592596.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Search Strategy &#40;Trip Database Key Words and MeSH Terms&#41;&#46;</p>"
        ]
      ]
      1 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Clinical Question&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total References Selected&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total References Retrieved from Trip&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total References Retrieved from MeSH&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total References Selected to Answer the Question&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Types of Study Selected&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Does spirometry motivate the smoker with COPD to stop smoking&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 systematic reviews<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">10&#44;11</span></a><br>4 RCTs<a class="elsevierStyleCrossRefs" href="#bib0250"><span class="elsevierStyleSup">12&#44;14&#8211;16</span></a><br>1 cohort study<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">13</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Is the treatment of smoking different between smokers with and without COPD&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 systematic reviews<a class="elsevierStyleCrossRefs" href="#bib0275"><span class="elsevierStyleSup">17&#8211;19</span></a><br>2 meta-analyses<a class="elsevierStyleCrossRefs" href="#bib0290"><span class="elsevierStyleSup">20&#44;22</span></a><br>4 RCTs<a class="elsevierStyleCrossRefs" href="#bib0295"><span class="elsevierStyleSup">21&#44;23&#8211;25</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Is smoking cessation intervention effective in hospitalized smokers with COPD&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 systematic review<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">29</span></a><br>3 RCTs<a class="elsevierStyleCrossRefs" href="#bib0340"><span class="elsevierStyleSup">30&#44;32&#44;33</span></a><br>1 economic evaluation<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">31</span></a><br>1 cohort study<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">34</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Would funding the treatment of smoking in smokers with COPD impact on health economics&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 case&#8211;control study<a class="elsevierStyleCrossRef" href="#bib0365"><span class="elsevierStyleSup">35</span></a><br>3 cohort studies<a class="elsevierStyleCrossRefs" href="#bib0370"><span class="elsevierStyleSup">36&#8211;38</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1592597.png"
              ]
            ]
          ]
          "notaPie" => array:1 [
            0 => array:3 [
              "identificador" => "tblfn0005"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Manual capture by snow-balling&#58; 3 references&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Number and Type of Studies Selected to Answer the Clinical Questions&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:38 [
            0 => array:3 [
              "identificador" => "bib0195"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Global Strategy for Diagnosis&#44; Management&#44; and Prevention of COPD-2016&#46; Available from&#58; <a href="http://www.goldcopd.org/Guidelines/guidelines-resources.html">http&#58;&#47;&#47;www&#46;goldcopd&#46;org&#47;Guidelines&#47;guidelines-resources&#46;html</a> &#91;accessed 17&#46;04&#46;16&#93;&#46;"
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0200"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Smoking cessation in COPD"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "P&#46; Tonnesen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1183/09059180.00007212"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Respir Rev"
                        "fecha" => "2013"
                        "volumen" => "22"
                        "paginaInicial" => "37"
                        "paginaFinal" => "43"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23457163"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Normativa SEPAR&#46; Tratamiento del tabaquismo en fumadores con EPOC"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46;A&#46; Jimenez Ruiz"
                            1 => "J&#46;A&#46; Riesco Miranda"
                            2 => "N&#46; Altet G&#243;mez"
                            3 => "J&#46;J&#46; Lorza Blasco"
                            4 => "J&#46; Signes-Costa Mi&#241;ana"
                            5 => "S&#46; Solano Reina"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.arbres.2013.02.005"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Bronconeumol"
                        "fecha" => "2013"
                        "volumen" => "49"
                        "paginaInicial" => "354"
                        "paginaFinal" => "363"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23642760"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Statement on smoking cessation on COPD and other pulmonary diseases and in smokers with co-morbidities who find it difficult to quit"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46;A&#46; Jimenez Ruiz"
                            1 => "S&#46; Andreas"
                            2 => "K&#46;E&#46; Lewis"
                            3 => "P&#46; Tonnesen"
                            4 => "C&#46;P&#46; van Schayck"
                            5 => "P&#46; Hajek"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1183/09031936.00092614"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Respir J"
                        "fecha" => "2015"
                        "volumen" => "46"
                        "paginaInicial" => "61"
                        "paginaFinal" => "79"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25882805"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Smoking cessation strategies in patients with COPD"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46;J&#46; Warniers"
                            1 => "E&#46;E&#46; van Riet"
                            2 => "F&#46;H&#46; Rutten"
                            3 => "M&#46;L&#46; de Bruin"
                            4 => "A&#46;P&#46; Sachs"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Eur Respir J"
                        "fecha" => "2013"
                        "volumen" => "41"
                        "paginaInicial" => "27"
                        "paginaFinal" => "34"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Smoking cessation in chronic obstructive pulmonary disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "D&#46;P&#46; Tashkin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1055/s-0035-1555610"
                      "Revista" => array:6 [
                        "tituloSerie" => "Semin Respir Crit Care Med"
                        "fecha" => "2015"
                        "volumen" => "36"
                        "paginaInicial" => "491"
                        "paginaFinal" => "507"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26238637"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "GRADE guidelines&#58; 2&#46; Framing the question and deciding on important outcomes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "G&#46;H&#46; Guyatt"
                            1 => "A&#46;D&#46; Oxman"
                            2 => "R&#46; Kunz"
                            3 => "D&#46; Atkins"
                            4 => "J&#46; Brozek"
                            5 => "G&#46; Vist"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jclinepi.2010.09.012"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Epidemiol"
                        "fecha" => "2011"
                        "volumen" => "64"
                        "paginaInicial" => "395"
                        "paginaFinal" => "400"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21194891"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0230"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evidence-based medicine workbook&#46; Finding and applying the best evidence to improve patient care"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "P&#46; Glasziou"
                            1 => "C&#46;H&#46; del Mar"
                            2 => "J&#46; Salisbury"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:2 [
                        "fecha" => "2003"
                        "editorial" => "BMJ Books"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0235"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Grading strength of recommendations and quality of evidence in clinical guidelines&#58; report from an American College of Chest Physicians Task Force"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "G&#46; Guyatt"
                            1 => "D&#46; Gutterman"
                            2 => "M&#46;H&#46; Baumann"
                            3 => "D&#46; Addrizzo-Harris"
                            4 => "E&#46;M&#46; Hylek"
                            5 => "B&#46; Phillips"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1378/chest.129.1.174"
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "2006"
                        "volumen" => "129"
                        "paginaInicial" => "174"
                        "paginaFinal" => "181"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16424429"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0240"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Spirometry as a motivational tool to improve smoking cessation rates&#58; a systematic review of the literature"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "T&#46;J&#46; Wilt"
                            1 => "D&#46; Niewoehner"
                            2 => "R&#46;L&#46; Kane"
                            3 => "R&#46; MacDonald"
                            4 => "A&#46;M&#46; Joseph"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1080/14622200601078509"
                      "Revista" => array:6 [
                        "tituloSerie" => "Nicotine Tob Res"
                        "fecha" => "2007"
                        "volumen" => "9"
                        "paginaInicial" => "21"
                        "paginaFinal" => "32"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17365733"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0245"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:3 [
                  "comentario" => "CD004705"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Biomedical risk assessment as an aid for smoking cessation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "R&#46; Bize"
                            1 => "B&#46; Burnand"
                            2 => "Y&#46; Mueller"
                            3 => "M&#46; R&#232;geWalther"
                            4 => "J&#46; Cornuz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:3 [
                        "tituloSerie" => "Cochrane Database Syst Rev"
                        "fecha" => "2009"
                        "volumen" => "15"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0250"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effectiveness of individual counselling for smoking cessation in smokers with chronic obstructive pulmonary disease and asymptomatic smokers"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46; Chen"
                            1 => "Y&#46; Chen"
                            2 => "P&#46; Chen"
                            3 => "Z&#46; Liu"
                            4 => "H&#46; Luo"
                            5 => "S&#46; Cai"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3892/etm.2013.1463"
                      "Revista" => array:6 [
                        "tituloSerie" => "Exp Ther Med"
                        "fecha" => "2014"
                        "volumen" => "7"
                        "paginaInicial" => "716"
                        "paginaFinal" => "720"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24520273"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Smokers with airway obstruction are more likely to quit smoking"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Bednarek"
                            1 => "D&#46; Gorecka"
                            2 => "J&#46; Wielgomas"
                            3 => "M&#46; Czajkowska-Malinowska"
                            4 => "J&#46; Regula"
                            5 => "G&#46; Mieszko-Filipczyk"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/thx.2006.059071"
                      "Revista" => array:6 [
                        "tituloSerie" => "Thorax"
                        "fecha" => "2006"
                        "volumen" => "61"
                        "paginaInicial" => "869"
                        "paginaFinal" => "873"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16809415"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0260"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The impact of repeated spirometry and smoking cessation advice on smokers with mild COPD"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "G&#46; Stratelis"
                            1 => "S&#46; M&#246;lstad"
                            2 => "P&#46; Jakobsson"
                            3 => "O&#46; Zetterstr&#246;m"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Scan J Prim Health Care"
                        "fecha" => "2006"
                        "volumen" => "24"
                        "paginaInicial" => "133"
                        "paginaFinal" => "139"
                        "itemHostRev" => array:3 [
                          "pii" => "S074980631300159X"
                          "estado" => "S300"
                          "issn" => "07498063"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0265"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effect on smoking quit rate of telling patients their lung age&#58; the Step2quit randomised controlled trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "G&#46; Parker"
                            1 => "T&#46; Greenhalgh"
                            2 => "M&#46; Griffin"
                            3 => "R&#46; Dem"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/bmj.39503.582396.25"
                      "Revista" => array:6 [
                        "tituloSerie" => "BMJ"
                        "fecha" => "2008"
                        "volumen" => "336"
                        "paginaInicial" => "598"
                        "paginaFinal" => "600"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18326503"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0270"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Efficacy of confronting smokers with air flow limitation for smoking cessation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "D&#46; Kotz"
                            1 => "G&#46; Wesseling"
                            2 => "M&#46;J&#46; Huibers"
                            3 => "O&#46;C&#46; van Schayck"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1183/09031936.00116308"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Respir J"
                        "fecha" => "2009"
                        "volumen" => "33"
                        "paginaInicial" => "754"
                        "paginaFinal" => "762"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19129277"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0275"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:3 [
                  "comentario" => "CD002999"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Smoking cessation for chronic obstructive pulmonary disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "R&#46;M&#46; Van der Meer"
                            1 => "E&#46; Wagena"
                            2 => "R&#46;W&#46;J&#46;G&#46; Ostelo"
                            3 => "A&#46;J&#46;E&#46; Jacobs"
                            4 => "C&#46;P&#46; van Schayck"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:2 [
                        "tituloSerie" => "Cochrane Database Syst Rev"
                        "fecha" => "2003"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0280"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Long term effectiveness and cost&#47;effectiveness of smoking cessation interventions in patients with COPD"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46; Hoogendoon"
                            1 => "T&#46;L&#46; Feenstra"
                            2 => "R&#46;T&#46; Hoogenveen"
                            3 => "M&#46; Rutten-van M&#246;lken"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/thx.2009.131631"
                      "Revista" => array:6 [
                        "tituloSerie" => "Thorax"
                        "fecha" => "2010"
                        "volumen" => "65"
                        "paginaInicial" => "711"
                        "paginaFinal" => "718"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20685746"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0285"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:3 [
                  "comentario" => "Available from&#58; <span class="elsevierStyleInterRef" id="intr0020" href="http://www.hqontario.ca/en/mas/tech/pdfs/2012/rev_COPD_Smoking_Cessation_March.pdf">http&#58;&#47;&#47;www&#46;hqontario&#46;ca&#47;en&#47;mas&#47;tech&#47;pdfs&#47;2012&#47;rev&#95;COPD&#95;Smoking&#95;Cessation&#95;March&#46;pdf</span> &#91;accessed 06&#46;10&#46;16&#93;"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Smoking cessation for patients with chronic obstructive pulmonary disease&#58; an evidence-based analyses"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "COPD Working Group"
                          "etal" => false
                          "autores" => array:1 [
                            0 => "M&#46; Thabane"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ont Health Technol Assess Ser"
                        "fecha" => "2012"
                        "volumen" => "12"
                        "paginaInicial" => "1"
                        "paginaFinal" => "75"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23226812"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0290"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Smoking cessation interventions in COPD&#58; a network meta-analysis of randomized trials"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "R&#46; Strassman"
                            1 => "B&#46; Bausch"
                            2 => "A&#46; Spaar"
                            3 => "J&#46; Kleijnen"
                            4 => "O&#46; Braendli"
                            5 => "M&#46;A&#46; Puhan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1183/09031936.00167708"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Respir J"
                        "fecha" => "2009"
                        "volumen" => "34"
                        "paginaInicial" => "634"
                        "paginaFinal" => "640"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19357145"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0295"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "High rates of smoking abstinence in COPD patients&#58; smoking cessation by hospitalization"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "B&#46;M&#46; Sundblad"
                            1 => "K&#46; Larsson"
                            2 => "L&#46; Nathell"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1080/14622200802023890"
                      "Revista" => array:6 [
                        "tituloSerie" => "Nicotine Tob Res"
                        "fecha" => "2008"
                        "volumen" => "10"
                        "paginaInicial" => "883"
                        "paginaFinal" => "890"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18569763"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0300"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effective behaviour change techniques in smoking cessation interventions for people with chronic obstructive pulmonary disease&#58; a meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "Y&#46;L&#46; Bartlett"
                            1 => "P&#46; Sheeran"
                            2 => "M&#46;S&#46; Hawley"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/bjhp.12071"
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Health Psychol"
                        "fecha" => "2014"
                        "volumen" => "19"
                        "paginaInicial" => "181"
                        "paginaFinal" => "203"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24397814"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0305"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Smoking cessation in patients with chronic obstructive pulmonary disease&#58; a double-blind&#44; placebo-controlled&#44; randomised trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46;P&#46; Tashkin"
                            1 => "R&#46; Kanner"
                            2 => "W&#46; Bailey"
                            3 => "S&#46; Buist"
                            4 => "P&#46; Anderson"
                            5 => "M&#46; Nides"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2001"
                        "volumen" => "357"
                        "paginaInicial" => "1571"
                        "paginaFinal" => "1575"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11377644"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S1058274613004321"
                          "estado" => "S300"
                          "issn" => "10582746"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0310"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Efficacy of bupropion and nortriptyline for smoking cessation among people at risk for or with COPD"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "E&#46;J&#46; Wagena"
                            1 => "P&#46;G&#46; Knispchild"
                            2 => "M&#46;J&#46; Huibers"
                            3 => "E&#46;F&#46; Wouters"
                            4 => "C&#46;P&#46; van Schayk"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/archinte.165.19.2286"
                      "Revista" => array:7 [
                        "tituloSerie" => "Arch Intern Med"
                        "fecha" => "2005"
                        "volumen" => "165"
                        "paginaInicial" => "2286"
                        "paginaFinal" => "2292"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16246996"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S1058274614003267"
                          "estado" => "S300"
                          "issn" => "10582746"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0315"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effects of varenicline on smoking cessation in patients with mild to moderate COPD&#58; a randomized controlled trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "D&#46;P&#46; Tashkin"
                            1 => "S&#46; Rennard"
                            2 => "J&#46;T&#46; Hays"
                            3 => "D&#46; Lawrence"
                            4 => "J&#46;P&#46; Marton"
                            5 => "T&#46;C&#46; Lee"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1378/chest.10-0865"
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "2011"
                        "volumen" => "139"
                        "paginaInicial" => "591"
                        "paginaFinal" => "599"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20864613"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0320"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:3 [
                  "comentario" => "CD010744"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Smoking cessation for people with chronic obstructive pulmonary disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "E&#46;A&#46; Van Eerd"
                            1 => "R&#46;M&#46; van der Meer"
                            2 => "O&#46;C&#46; van Schayck"
                            3 => "D&#46; Kotz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:2 [
                        "tituloSerie" => "Cochrane Database Syst Rev"
                        "fecha" => "2016"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0325"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Depressive symptoms and chronic obstructive pulmonary disease&#58; effect on mortality&#44; hospital readmission&#44; symptom burden&#44; functional status&#44; and quality of life"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "T&#46;P&#46; Ng"
                            1 => "M&#46; Niti"
                            2 => "W&#46;C&#46; Tan"
                            3 => "Z&#46; Cao"
                            4 => "K&#46;C&#46; Ong"
                            5 => "P&#46; Eng"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/archinte.167.1.60"
                      "Revista" => array:7 [
                        "tituloSerie" => "Arch Intern Med"
                        "fecha" => "2007"
                        "volumen" => "167"
                        "paginaInicial" => "60"
                        "paginaFinal" => "67"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17210879"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0749806316002668"
                          "estado" => "S300"
                          "issn" => "07498063"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0330"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:3 [
                  "comentario" => "Traducci&#243;n al espa&#241;ol&#58; Gu&#237;a de tratamiento del tabaquismo &#40;Jim&#233;nez Ruiz CA&#44; Ja&#233;n CR&#44; coordinadores de la traducci&#243;n&#41;&#46; Sociedad Espa&#241;ola de Neumolog&#237;a y Cirug&#237;a Tor&#225;cica&#46; SEPAR&#46; Mayo 2010&#46; Eden Artes Gr&#225;ficas S&#46;L&#46;&#44; Madrid&#58; 2010&#46;"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Treating tobacco use dependence&#58; 2008 update&#46; Clinical practice guideline"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;C&#46; Fiore"
                            1 => "C&#46;R&#46; Ja&#233;n"
                            2 => "T&#46;B&#46; Baker"
                            3 => "W&#46;C&#46; Baily"
                            4 => "N&#46; Benowitz"
                            5 => "S&#46;J&#46; Curry"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "2008"
                        "editorial" => "U&#46;S&#46; Department of Health and Human Services&#44; Public Health Service"
                        "editorialLocalizacion" => "Rockville&#44; MD"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0335"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:3 [
                  "comentario" => "Issue 5 Art&#46; No&#46;&#58; CD001837"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Interventions for smoking cessation in hospitalised patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "N&#46;A&#46; Rigotti"
                            1 => "C&#46; Clair"
                            2 => "M&#46;R&#46; Munaf&#242;"
                            3 => "L&#46;F&#46; Stead"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:2 [
                        "tituloSerie" => "Cochrane Database Syst Rev"
                        "fecha" => "2012"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0340"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sustained care intervention and postdischarge smoking cessation among hospitalized adults&#58; a randomized clinical trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "N&#46;A&#46; Rigotti"
                            1 => "S&#46; Regan"
                            2 => "D&#46;E&#46; Levy"
                            3 => "S&#46; Japuntich"
                            4 => "Y&#46; Chang"
                            5 => "E&#46;R&#46; Park"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/jama.2014.9237"
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA"
                        "fecha" => "2014"
                        "volumen" => "312"
                        "paginaInicial" => "719"
                        "paginaFinal" => "728"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25138333"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib0345"
              "etiqueta" => "31"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Economic evaluation of a hospital-initiated intervention for smokers with chronic disease&#44; in Ontario&#44; Canada"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "K&#46;A&#46; Mullen"
                            1 => "D&#46; Coyle"
                            2 => "D&#46; Manuel"
                            3 => "H&#46;V&#46; Nguyen"
                            4 => "B&#46; Pham"
                            5 => "A&#46;L&#46; Pipe"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/tobaccocontrol-2013-051483"
                      "Revista" => array:6 [
                        "tituloSerie" => "Tob Control"
                        "fecha" => "2015"
                        "volumen" => "24"
                        "paginaInicial" => "489"
                        "paginaFinal" => "496"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24935442"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib0350"
              "etiqueta" => "32"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The effectiveness of smoking cessation groups offered to hospitalised patients with symptoms of exacerbations of chronic obstructive pulmonary disease &#40;COPD&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46; Borglykke"
                            1 => "C&#46; Pisinger"
                            2 => "T&#46; J&#248;rgensen"
                            3 => "H&#46; Ibsen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1752-699X.2008.00055.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Respir J"
                        "fecha" => "2008"
                        "volumen" => "2"
                        "paginaInicial" => "158"
                        "paginaFinal" => "165"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20298324"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib0355"
              "etiqueta" => "33"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Predischarge bundle for patients with acute exacerbations of COPD to reduce readmissions and ED visits&#46; A randomized controlled trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46; Jennings"
                            1 => "K&#46; Thavarajah"
                            2 => "M&#46;P&#46; Mendez"
                            3 => "M&#46; Eichenhorn"
                            4 => "P&#46; Kvale"
                            5 => "L&#46; Yessayan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1378/chest.14-1123"
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "2015"
                        "volumen" => "147"
                        "paginaInicial" => "1227"
                        "paginaFinal" => "1234"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25940250"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib0360"
              "etiqueta" => "34"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Utilization and effectiveness of pharmacotherapy for tobacco use following admission for exacerbation of COPD"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46;C&#46; Melzer"
                            1 => "L&#46;C&#46; Feemster"
                            2 => "M&#46;P&#46; Collins"
                            3 => "D&#46;H&#46; Au"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/jhm.2519"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Hosp Med"
                        "fecha" => "2016"
                        "volumen" => "11"
                        "paginaInicial" => "257"
                        "paginaFinal" => "263"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26663891"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            34 => array:3 [
              "identificador" => "bib0365"
              "etiqueta" => "35"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The effect of quitting smoking on costs and healthcare utilization in patients with chronic obstructive pulmonary disease&#58; a comparison of current smokers versus ex-smokers in routine clinical practice"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46; Sicras-Mainar"
                            1 => "J&#46; Rejas-Guti&#233;rrez"
                            2 => "R&#46; Navarro-Artieda"
                            3 => "J&#46; Ib&#225;&#241;ez-Nolla"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Lung"
                        "fecha" => "2014"
                        "volumen" => "1"
                        "paginaInicial" => "505"
                        "paginaFinal" => "518"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            35 => array:3 [
              "identificador" => "bib0370"
              "etiqueta" => "36"
              "referencia" => array:1 [
                0 => array:3 [
                  "comentario" => "e24870"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Simulation-based estimates of effectiveness and cost-effectiveness of smoking cessation in patients with chronic obstructive pulmonary disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "K&#46; Atsou"
                            1 => "C&#46; Chouaid"
                            2 => "G&#46; Hejblum"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1371/journal.pone.0028413"
                      "Revista" => array:4 [
                        "tituloSerie" => "PLoS ONE"
                        "fecha" => "2011"
                        "volumen" => "6"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22162769"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            36 => array:3 [
              "identificador" => "bib0375"
              "etiqueta" => "37"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Budgetary impact analysis on funding smoking-cessation drugs in patients with COPD in Spain"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46; Jimenez-Ruiz"
                            1 => "S&#46; Solano-Reina"
                            2 => "J&#46; Signes-Costa"
                            3 => "E&#46; de Higes-Martinez"
                            4 => "J&#46;I&#46; Granda-Orive"
                            5 => "J&#46;J&#46; Lorza-Blasco"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2147/COPD.S87597"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Chron Obstruct Pulmon Dis"
                        "fecha" => "2015"
                        "volumen" => "10"
                        "paginaInicial" => "2027"
                        "paginaFinal" => "2036"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26451100"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            37 => array:3 [
              "identificador" => "bib0380"
              "etiqueta" => "38"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cost effectiveness of free access to smoking cessation treatment in France considering the economic burden of smoking related diseases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "B&#46; Cadler"
                            1 => "I&#46; Durand-Zaleski"
                            2 => "D&#46; Thomas"
                            3 => "K&#46; Chevreul"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1371/journal.pone.0148750"
                      "Revista" => array:5 [
                        "tituloSerie" => "PLOS ONE"
                        "fecha" => "2016"
                        "volumen" => "11"
                        "paginaInicial" => "e0148750"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26909802"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
    "agradecimientos" => array:1 [
      0 => array:3 [
        "titulo" => "Acknowledgements"
        "texto" => "<p id="par0365" class="elsevierStylePara elsevierViewall">We thank Dr&#46; &#193;ngela Ramos Pinedo &#40;Hospital Fundaci&#243;n Alcorc&#243;n&#44; Madrid&#44; Spain&#41; and Dr&#46; Susana Luhning &#40;Professor of the Department of Internal Medicine&#47;Respiratory Medicine&#44; Facultad de Medicina&#44; Universidad de C&#243;rdoba&#44; Argentina&#41;&#44; who acted as external reviewers of this document&#46;</p>"
        "vista" => "all"
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/15792129/0000005300000011/v2_201711201359/S1579212917302987/v2_201711201359/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "47123"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Special Article"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/15792129/0000005300000011/v2_201711201359/S1579212917302987/v2_201711201359/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212917302987?idApp=UINPBA00003Z"
]

Article information

ISSN: 15792129
Original language: English

DOI:10.1016/j.arbr.2017.04.018

The statistics are updated each day

Year/Month	Html	Pdf	Total

2024 November	7	2	9
2024 October	175	36	211
2024 September	178	32	210
2024 August	125	38	163
2024 July	127	41	168
2024 June	135	30	165
2024 May	213	33	246
2024 April	88	59	147
2024 March	106	19	125
2024 February	66	20	86
2023 September	1	2	3
2023 March	40	5	45
2023 February	168	32	200
2023 January	100	47	147
2022 December	148	39	187
2022 November	196	44	240
2022 October	199	64	263
2022 September	160	43	203
2022 August	201	55	256
2022 July	84	72	156
2022 June	125	47	172
2022 May	196	46	242
2022 April	169	54	223
2022 March	166	63	229
2022 February	195	49	244
2022 January	216	63	279
2021 December	122	69	191
2021 November	188	52	240
2021 October	281	103	384
2021 September	202	82	284
2021 August	248	60	308
2021 July	164	43	207
2021 June	128	72	200
2021 May	170	60	230
2021 April	572	144	716
2021 March	425	61	486
2021 February	243	34	277
2021 January	231	22	253
2020 December	157	37	194
2020 November	203	37	240
2020 October	228	45	273
2020 September	264	21	285
2020 August	211	35	246
2020 July	242	43	285
2020 June	216	24	240
2020 May	199	22	221
2020 April	196	29	225
2020 March	162	31	193
2020 February	174	44	218
2020 January	139	41	180
2019 December	92	37	129
2019 November	110	51	161
2019 October	128	55	183
2019 September	123	54	177
2019 August	89	37	126
2019 July	81	39	120
2019 June	35	34	69
2019 May	44	44	88
2019 April	74	55	129
2019 March	44	54	98
2019 February	36	42	78
2019 January	33	28	61
2018 December	47	22	69
2018 November	124	45	169
2018 October	205	30	235
2018 September	132	17	149
2018 May	29	0	29
2018 April	37	24	61
2018 March	67	31	98
2018 February	44	34	78
2018 January	12	0	12
2017 November	2	0	2

Show all

Indexed in:

Follow us:

Subscribe:

Statistics

Indexed in:

Follow us:

Subscribe:

Statistics

Subscribe to our newsletter