L\u2019\u00e9tude porte sur un dispositif pilote de prise en charge de la d\u00e9pendance au tabac pour les personnes atteintes de troubles mentaux s\u00e9v\u00e8res (Severe Mental Illness, SMI) mis en place par NHS England sur sept sites en Angleterre. Ce public pr\u00e9sente des taux de tabagisme plus \u00e9lev\u00e9s que la population g\u00e9n\u00e9rale, avec des in\u00e9galit\u00e9s de sant\u00e9 marqu\u00e9es et une esp\u00e9rance de vie r\u00e9duite. L\u2019objectif de l\u2019\u00e9valuation rapide \u00e9tait de d\u00e9crire les modalit\u00e9s de mise en \u0153uvre de ces services, la mani\u00e8re dont leur succ\u00e8s est d\u00e9fini et mesur\u00e9, l\u2019organisation des parcours de recours et les co\u00fbts de d\u00e9livrance.<\/p>\n
L\u2019\u00e9valuation a combin\u00e9 plusieurs m\u00e9thodes : entretiens avec des professionnels des services (11 personnes), enqu\u00eate par questionnaire aupr\u00e8s de personnels de service (42 r\u00e9ponses), ateliers avec des personnes ayant une exp\u00e9rience v\u00e9cue du tabagisme et d\u2019un SMI (15 participants), ainsi qu\u2019un atelier r\u00e9unissant NHS England et les responsables des sites pilotes. Cette approche visait \u00e0 documenter \u00e0 la fois les pratiques, les perceptions des acteurs et les aspects organisationnels et financiers.<\/p>\n
Les r\u00e9sultats indiquent que la prise en charge est largement individualis\u00e9e et adapt\u00e9e aux besoins sp\u00e9cifiques des personnes avec SMI. Les professionnels comme les usagers jugent que des indicateurs plus larges, tels que l\u2019\u00e9tat de sant\u00e9 physique global et l\u2019exp\u00e9rience utilisateur, sont plus pertinents que le seul taux d\u2019abstinence tabagique \u00e0 28 jours, habituellement utilis\u00e9 dans les services g\u00e9n\u00e9riques de sevrage tabagique. Ceci interroge la pertinence d\u2019indicateurs standardis\u00e9s limit\u00e9s \u00e0 la cessation \u00e0 court terme pour ce public.<\/p>\n
L\u2019\u00e9tude montre \u00e9galement que le d\u00e9veloppement et l\u2019\u00e9largissement des voies d\u2019orientation vers ces services n\u00e9cessitent des ressources importantes et se heurtent \u00e0 de nombreux obstacles, notamment des id\u00e9es re\u00e7ues sur la motivation des personnes souffrant de SMI \u00e0 arr\u00eater de fumer. Ces barri\u00e8res limitent l\u2019acc\u00e8s effectif au dispositif malgr\u00e9 les besoins identifi\u00e9s. Sur le plan \u00e9conomique, l\u2019acc\u00e8s \u00e0 des donn\u00e9es compl\u00e8tes sur les co\u00fbts a \u00e9t\u00e9 difficile dans les diff\u00e9rents sites, ce qui emp\u00eache de d\u00e9terminer pr\u00e9cis\u00e9ment le co\u00fbt r\u00e9el de mise en \u0153uvre et de fonctionnement de ces services sp\u00e9cialis\u00e9s.<\/p>\n
Les auteurs soulignent l\u2019importance d\u2019un service sp\u00e9cifiquement adapt\u00e9 aux personnes atteintes de SMI, tout en pointant plusieurs limites pour le pilotage public : insuffisante prise en compte d\u2019indicateurs plus larges de r\u00e9sultats pour les usagers, manque de donn\u00e9es consolid\u00e9es sur les co\u00fbts, et obstacles persistants au niveau des parcours de recours. Ces \u00e9l\u00e9ments peuvent pr\u00e9senter un int\u00e9r\u00eat pour la r\u00e9flexion des administrations sur la conception, le suivi et l\u2019\u00e9valuation de dispositifs ciblant des publics en grande vuln\u00e9rabilit\u00e9 en mati\u00e8re de sant\u00e9 mentale et de tabagisme.(contenu r\u00e9sum\u00e9 en fran\u00e7ais par l’IA)\u00a0Lire la Suite<\/a><\/p>","protected":false},"excerpt":{"rendered":" L\u2019\u00e9tude porte sur un dispositif pilote de prise en charge de la d\u00e9pendance au tabac pour les personnes atteintes de troubles mentaux s\u00e9v\u00e8res (Severe Mental Illness, SMI) mis en place […]<\/p>\n","protected":false},"author":1,"featured_media":10675,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[26],"tags":[234,227,226],"class_list":["post-14979","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-donnees-etudes-evaluation-et-prospective","tag-rand","tag-ia","tag-sources-etrangeres"],"_links":{"self":[{"href":"https:\/\/veilles-affaires-sociales.fr\/index.php?rest_route=\/wp\/v2\/posts\/14979","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/veilles-affaires-sociales.fr\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/veilles-affaires-sociales.fr\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/veilles-affaires-sociales.fr\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/veilles-affaires-sociales.fr\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=14979"}],"version-history":[{"count":0,"href":"https:\/\/veilles-affaires-sociales.fr\/index.php?rest_route=\/wp\/v2\/posts\/14979\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/veilles-affaires-sociales.fr\/index.php?rest_route=\/wp\/v2\/media\/10675"}],"wp:attachment":[{"href":"https:\/\/veilles-affaires-sociales.fr\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=14979"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/veilles-affaires-sociales.fr\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=14979"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/veilles-affaires-sociales.fr\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=14979"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}