scholarly journals Who Opted Out of an Opt-Out Smoking-Cessation Programme for Hospitalised Patients?

2016 ◽  
Vol 12 (4) ◽  
pp. 199-204 ◽  
Author(s):  
Georges J. Nahhas ◽  
K. Michael Cummings ◽  
Vince Talbot ◽  
Matthew J. Carpenter ◽  
Benjamin A. Toll ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
South Carolina ◽  
Smoking History ◽  
Post Discharge ◽  
Smoking Cessation Programme ◽  
Phone Calls ◽  
Opt Out ◽  
Hospitalised Patients ◽  
Log Linear

Introduction: The Medical University of South Carolina (MUSC) hospital implemented an inpatient opt-out smoking-cessation service where smokers received a mandatory smoking-cessation consult and phone follow-up within 1-month post-discharge.Aim: To examine predictors of patients who opted-out of bedside counselling or follow-up phone calls.Methods: Eligible adult cigarette smokers admitted to the MUSC hospital were enrolled in the programme. Opting-out of bedside consult or follow-up calls were assessed separately using log-linear modelling where predictors included patient demographics, length of hospitalisation, insurance type, smoking history, and motivation/confidence to quit.Results: Of the 38,758 admitted patients (February 2014–May 2015), 6,684 reported currently smoking and were automatically referred to bedside-consult. Approximately 26% of smokers made contact with the counselor, most of whom (83%) accepted the consult. Amongst patients eligible for post-discharge follow-up (n = 3485), 49% responded to the calls. Those who opted-out of the bedside-consult were mostly males (RR = 1.29). Those who did not respond to follow-up calls were younger age (RR = 1.33), with Medicaid/no insurance (RR = 1.17), and had not received a bedside consult (RR = 1.32).Conclusions: An opt-out smoking-cessation programme was feasible and acceptable to most patients and was able to reach 65% of eligible smokers; 17% opted-out of bedside counselling; <1% asked to be removed from further phone calls.

Abstract TP288: Overcoming Obstacles Making People Healthy (OOMPH): A Patient Centered Post Discharge Follow-up Program for Stroke Patients

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Jonathan Muller ◽  
Barbara Gatton ◽  
Linda Fox ◽  
Joseph A Bove ◽  
Johanna Donovan Turner ◽  
...  
Keyword(s):  
Support Groups ◽  
Medical Information ◽  
Patient Adherence ◽  
Hospital Readmissions ◽  
Phone Call ◽  
Stroke Patients ◽  
Post Discharge ◽  
Phone Calls ◽  
Stroke Support Groups

Background and Purpose: At least 12% of stroke patients are readmitted to a hospital within 30 days of discharge. We know that patients hospitalized for other conditions are less likely to be readmitted within 30 days if they are seen by their PCP shortly after discharge. However, less than a third of patients in the New York metropolitan area admitted for heart failure, heart attacks, and pneumonia see their PCP within 14 days after discharge and nearly 40% of patients do not adhere to their prescribed regimen. In the case of cerebrovascular diseases, outpatient follow-up may prevent the majority of avoidable readmissions. The purpose of this project is to identify and reduce unnecessary, unplanned hospital readmissions after stroke. Our goal is to encourage patient adherence to prescribed medication and other therapies, as well as to ensure timely follow-up with their PCP. Methods: Stroke and transient ischemic attack (TIA) patients with a disposition of either home or short-term rehabilitation are visited and offered enrollment. Participants are given a kit which includes a personalized binder (to manage essential medical information) and a 28-slot pill box. Each patient then receives 3 phone call interviews at 7, 21 and 32 days after discharge. The aim of the phone calls is to identify obstacles to compliance with treatment regimen and follow-up care. Results: From January 2015 to June 2016, 247 patients were enrolled and followed up. Within 30 days of discharge, 10% were readmitted and 50% of all readmissions occurred within the first 7 days. Of those readmitted, 19% were due to an injury from physical therapy. Data from follow-up phone calls revealed that 83% were taking all prescribed medications, 89% had completed a follow-up with any physician, 69% were using the binder, and 61% had done all three. Conclusions: While we have not enrolled enough patients to see a statistically significant reduction in readmissions, our interviews showed that weather, depression, as well as a lack of insurance, family support, and a home health aide are all determinants on how patients will follow their prescribed regimen. The results of this study have allowed us to begin implementing stroke support groups and pre-discharge follow-up appointment scheduling.

scholarly journals Durability of Smoking Cessation for Elective Lower Extremity Orthopaedic Surgery

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0039
Author(s):  
Danica H. Smith ◽  
Michael F. McTague ◽  
Michael J. Weaver ◽  
Jeremy T. Smith
Keyword(s):  
Smoking Cessation ◽  
Lower Extremity ◽  
Orthopaedic Surgery ◽  
Perioperative Complications ◽  
Smoking History ◽  
Secondary Outcome ◽  
Impaired Wound Healing ◽  
Patient Reported ◽  
The Impact

Category: General Health Introduction/Purpose: Smoking tobacco is a risk factor for impaired wound healing, infection, delayed fracture healing, and prolonged hospital stay. Smoking cessation prior to surgery has shown a 40% relative risk reduction in total perioperative complications. The primary purpose of this study is to evaluate the impact of preoperative smoking cessation on long-term smoking habits in patients undergoing elective lower extremity orthopaedic surgery. The secondary outcome is patient-reported effectiveness of smoking cessation method. Methods: A retrospective cohort study was performed by identifying all patients who were smokers that were required to quit and subsequently had a normal nicotine/cotinine serum test prior to lower extremity orthopaedic surgery. Attempts were made to contact all patients and administer a survey inquiring about demographics, medical history, smoking history, smoking cessation process, and current smoking status. Results: Of 36 eligible patients, 23 completed the survey. Eleven patients identified as current non-smokers (48%) at the time of survey follow-up (mean follow-up 55 months with a range of 12 to 88 months). Of these 11, 82% said they were very likely to continue to refrain from smoking. Twelve patients identified as current smokers at the time of survey, over half of whom ceased smoking for at least three months perioperatively. The reasons for resuming smoking were “stress” (45%), ”falling back into the habit” (37%), and due to “friends who smoke” (18%). The majority of smoking patients (92%) decreased the number of cigarettes they smoked regularly. The most effective smoking cessation techniques were ”cold turkey”, “non-nicotine medication”, and ”trans-dermal nicotine patches”. Conclusion: Elective surgery offers a unique opportunity for smoking cessation. Of 23 patients required to quit smoking prior to surgery, 48% maintained smoking cessation at least one year postoperatively. Of the 12 patients who relapsed, 55% stated that they did not resume smoking until at least three months postoperatively, suggesting that this particular period may be an important time for intensified smoking cessation counseling.

Preliminary Investigation of a Culturally Specific Smoking Cessation Intervention for Hispanic Smokers

1997 ◽  
Vol 11 (3) ◽  
pp. 198-207 ◽  
Author(s):  
Jeffrey S. Nevid ◽  
Rafael A. Javier
Keyword(s):  
Smoking Cessation ◽  
Smoking Cessation Intervention ◽  
The Self ◽  
Smoking History ◽  
Culturally Specific ◽  
Significant Group ◽  
Self Help ◽  
Cessation Intervention ◽  
Self Help Group

Purpose. The purpose of this study was to compare a culturally specific, multicomponent behavioral smoking cessation program for Hispanic smokers with a low-intensity, enhanced self-help control condition. Design. Participants who completed pretreatment assessment were randomly assigned to treatment conditions. Smoking status was evaluated at posttreatment, 6-month follow-up, and 12-month follow-up intervals. Setting. The study was based in predominantly Hispanic neighborhoods in Queens, New York. Participants. Ninety-three Hispanic smokers participated: 48 men and 45 women. Intervention. The multicomponent treatment involved a clinic-based group program that incorporated a culturally specific component consisting of videotaped presentations of culturally laden smoking-related vignettes. The self-help control program was enhanced by the use of an introductory group session and follow-up supportive telephone calls. Measures. Smoking outcomes were based on cotinine-validated abstinence and self-reported smoking rates. Predictors of abstinence were examined, including sociodemographic variables, smoking history, nicotine dependence, acculturation, partner interactions, reasons for quitting, self-efficacy, and linguistic competence. Results. Significant group differences in cotinine-validated abstinence rates in favor of the multicomponent group were obtained, but only at posttreatment. With missing data included and coded for nonabstinence, validated abstinence rates at posttreatment were 21% for the multicomponent group and 6% for the self-help group. At the 6-month follow-up, the rates were 13% for the multicomponent group and 9% for the self-help group. By the 12-month follow-up, the rates declined to 8% and 7% for the multicomponent and self-help groups, respectively. A dose-response relationship between attendance at group sessions and abstinence status was shown at posttreatment and 6-month follow-up intervals. Conclusions. The results of the present study failed to show any long-term benefit from use of a clinic-based, culturally specific multicomponent smoking cessation intervention for Hispanic smokers relative to a minimal-contact, enhanced self-help control.

scholarly journals Promoting cessation in hospitalized smoking patients: a systematic review

2020 ◽  
Vol 66 (6) ◽  
pp. 849-860
Author(s):  
Lígia Menezes do Amaral ◽  
Ângela Caroline Dias Albino Destro de Macêdo ◽  
Isabella Oliveira Lanzieri ◽  
Rafaela de Oliveira Andrade ◽  
Kimber P. Richter ◽  
...  
Keyword(s):  
Systematic Review ◽  
Smoking Cessation ◽  
Randomized Clinical Trials ◽  
Web Of Science ◽  
Communication Technologies ◽  
Post Discharge ◽  
Effective Strategies ◽  
Promote Smoking Cessation ◽  
Meta Analyses

SUMMARY OBJECTIVES The objective of this review was to evaluate high intensity post-discharge follow-up strategies to promote smoking cessation in hospitalized patients. METHODS A systematic review was performed, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA – P) protocol. The databases used for research were: PubMed, LILACS/BIREME, Scopus, Web of Science, Cochrane and Scielo. The included articles were randomized clinical trials, published from 1990 to 2018, which evaluated in-hospital and post-discharge intervention, and provided a minimum of 30-day care post discharge. The studies aimed to evaluate tobacco cessation. RESULTS Fourteen studies were selected for analysis. Across studies, pharmacotherapy was consistently effective for smoking cessation. Communication technologies likewise were consistently effective for cessation and post-discharge access. CONCLUSION Effective strategies exist. The challenge for future trials is to determine the best approaches for different clinical contexts, to promote cessation.

scholarly journals Efficiency and acceptability of an automated electronic system (DayCOR) compared with a telephone call system, for follow-up of day surgery patients

2019 ◽  
Vol 47 (3) ◽  
pp. 242-250 ◽  
Author(s):  
Nicole LT Tan ◽  
John R Sestan
Keyword(s):  
Demographic Data ◽  
Electronic System ◽  
Day Surgery ◽  
Telephone Call ◽  
Healthcare Organisation ◽  
Post Discharge ◽  
Phone Calls ◽  
Patient Reported ◽  
Call System

Post-discharge phone calls are a widely used yet suboptimal method of ascertaining recovery of day surgery patients. We compared the efficiency of an automated electronic system of follow-up, the Day Care Anaesthesia Outcomes Recording Registry (DayCOR), and a telephone call system that was standard practice in our non-profit private healthcare organisation in Victoria, Australia. We also surveyed a group of clinicians to assess their acceptance of DayCOR compared with the telephone call system. DayCOR is a web-based system which collects, alerts, manages and analyses patient-reported outcomes. Patients may opt in to respond to a 15-question survey via a link sent by text message or email. DayCOR’s patient response rate was 77.5%, compared with 66.0% for the telephone call system. Both systems collected data on clinical, process, and experience outcomes. Completeness of data collection was 100% using DayCOR compared with 51%–61.4% of data items using the telephone call system. We estimated that replacing our telephone call system with DayCOR to follow up 60,000 day surgery patients a year would represent an annual cost reduction of AUD$101,345 (53%) using manual demographic data entry, and AUD$142,745 (74%) if DayCOR was integrated with the institution’s existing administrative software. Seventy-eight percent of day surgery nurses and 94% of anaesthetists preferred DayCOR to the telephone call system. All anaesthetists surveyed stated that DayCOR provided more valuable feedback, and almost one-fifth had changed their clinical practice as a result. DayCOR’s efficiency and acceptability will allow more effective collection of post-discharge patient outcomes than is currently possible in our institution, and will support interventional studies aimed at improving quality of recovery of day surgery patients.

scholarly journals Implementation of a Pharmacist-Led Inpatient Tobacco Cessation Intervention in a Rehabilitation Hospital: A Before-and-After Pilot Study

2018 ◽  
Vol 71 (3) ◽  
Author(s):  
Vivian W Li ◽  
James Lam ◽  
Pam Heise ◽  
Robert D Reid ◽  
Kerri A Mullen
Keyword(s):  
Smoking Cessation ◽  
Pilot Study ◽  
Hospital Stay ◽  
Inpatient Rehabilitation ◽  
Smoking History ◽  
Rehabilitation Hospital ◽  
Mise En Œuvre ◽  
Cessation Intervention ◽  
Before And After

<p><strong>ABSTRACT</strong></p><p><strong>Background: </strong>Inpatient rehabilitation presents a unique opportunity for smoking interventions, given the typical lengths of stay, the relevance of smoking to the admission diagnosis of many patients, and the occurrence of nicotine withdrawal during the hospital stay.</p><p><strong>Objective: </strong>To evaluate the feasibility of implementing a pharmacist-led version of the Ottawa Model for Smoking Cessation (OMSC) program at a rehabilitation hospital, using the indicators of reach, effectiveness, adoption, and implementation.</p><p><strong>Methods: </strong>A before-and-after pilot study was conducted. Smoking cessation data were collected from 2 cohorts of eligible smokers identified during 4-month periods before (control) and after (intervention) implementation of the OMSC program. Control participants received usual care (i.e., no cessation intervention). Intervention participants received initial in-hospital smoking cessation support (counselling and nicotine replacement therapy), inpatient follow-up during the hospital stay, and 3 months of postdischarge follow-up calls, with all aspects led by hospital pharmacists.</p><p><strong>Results: </strong>Among all patients admitted to participating inpatient rehabilitation units during the 2 study periods, smoking prevalence was 7.8% (127/1626). After exclusions, deaths, and withdrawals, 111 patients were retained for analysis: 55 in the control group and 56 in the intervention group. The overall mean age of participants was 64.9 (standard deviation [SD] 14.3) years, with a mean smoking history of 35.0 (SD 24.8) pack-years. There were no significant differences between groups in terms of baseline characteristics. Self-reported abstinence rates (determined 3 months after discharge) were higher after compared with before implementation of the OMSC program: for continuous abstinence, 16/56 (28.6%) versus 9/55 (16.4%), <strong>_</strong>2 = 4.462, <em>p </em>= 0.035; for 7-day point prevalence abstinence, 21/56 (37.5%) versus 10/55 (18.2%), <strong>_</strong>2 = 6.807, <em>p </em>= 0.009.</p><p><strong>Conclusions: </strong>Implementation of the OMSC program at a large rehabilitation hospital was feasible and led to an increase in 3-month smoking abstinence. This study provides preliminary evidence to support inclusion of smoking interventions as part of inpatient rehabilitation care.</p><p><strong>RÉSUMÉ</strong></p><p><strong>Contexte : </strong>La réadaptation des patients hospitalisés représente une occasion unique de procéder à des interventions de désaccoutumance du tabac, notamment en raison de la durée habituelle des séjours, du rapport entre le tabagisme et le diagnostic posé à l’admission, et de la survenue du syndrome de sevrage de la nicotine durant le séjour.</p><p><strong>Objectif : </strong>Étudier la possibilité de mettre en oeuvre une version dirigée par des pharmaciens du programme Modèle d’Ottawa pour l’abandon du tabac (MOAT) dans un centre de réadaptation en employant les indicateurs pour la portée, l’efficacité, l’adoption et la mise en oeuvre.</p><p><strong>Méthodes : </strong>Une étude pilote avant-après a été menée. Des données sur la désaccoutumance ont été recueillies auprès de deux cohortes de fumeurs admissibles qui ont été repérés pendant des périodes de quatre mois avant (groupe témoin) et après (groupe expérimental) la mise en oeuvre du programme du MOAT. Les participants du groupe témoin ont reçu les soins habituels (c.-à-d. sans intervention de désaccoutumance). Les participants du groupe expérimental ont reçu un soutien initial à l’hôpital pour la désaccoutumance du tabac (des conseils et un traitement de remplacement de la nicotine), un suivi pendant le séjour à l’hôpital, et des appels de suivi pendant les trois mois suivant le congé, le tout sous la direction de pharmaciens d’hôpitaux.</p><p><strong>Résultats : </strong>Parmi l’ensemble des patients admis dans les unités de réadaptation participantes au cours des deux périodes de l’étude, la prévalence du tabagisme était de 7,8 % (127/1626). Mis à part les exclusions, les décès et les abandons, 111 patients ont été retenus pour l’analyse : 55 dans le groupe témoin et 56 dans le groupe expérimental. L’âge moyen des participants était de 64,9 (écart-type de 14,3) ans et leur antécédent de tabagisme moyen était de 35,0 (écart-type de 24,8) paquets-années. Aucune différence significative n’a été relevée entre les groupes en ce qui touche aux caractéristiques de base. Les taux d’abstinence autodéclarée (déterminée 3 mois après le congé) étaient plus élevés après la mise en oeuvre du programme du MOAT : pour une abstinence continue, 16/56 (28,6 %) contre 9/55 (16,4 %), <strong>_</strong>2 = 4,462, <em>p </em>= 0,035; pour une abstinence ponctuelle de sept jours consécutifs, 21/56 (37,5 %) contre 10/55 (18,2 %), <strong>_</strong>2 = 6,807, <em>p </em>= 0,009.</p><p><strong>Conclusions : </strong>La mise en oeuvre du programme du MOAT dans un important centre de réadaptation a été possible et a mené à une amélioration de l’abstinence du tabac à trois mois. Cette étude donne des résultats préliminaires en appui à l’inclusion d’interventions de désaccoutumance du tabac aux soins de réadaptation de patients hospitalisés.</p>

scholarly journals Increasing access to smoking cessation treatment among Latino smokers using case management

2019 ◽  
Vol 14 (3) ◽  
pp. 168-175
Author(s):  
Francisco Cartujano-Barrera ◽  
Jaime Perales ◽  
Evelyn Arana ◽  
Lisa Sanderson Cox ◽  
Hung-Wen Yeh ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Case Management ◽  
Smoking Status ◽  
Educational Materials ◽  
Smoking Cessation Treatment ◽  
Assistance Programs ◽  
Intention To Treat ◽  
Phone Calls ◽  
Cessation Treatment

AbstractIntroductionDisparities exist among Latino smokers with respect to knowledge and access to smoking cessation resources. This study tested the feasibility of using case management (CM) to increase access to pharmacotherapy and quitlines among Latino smokers.MethodsLatino smokers were randomized to CM (n = 40) or standard care (SC, n = 40). All participants received educational materials describing how to utilize pharmacy assistance for cessation pharmacotherapy and connect with quitlines. CM participants received four phone calls from staff to encourage pharmacotherapy and quitline use. At 6-months follow-up, we assessed the utilization of pharmacotherapy and quitline. Additional outcomes included self-reported smoking status and approval for pharmacotherapy assistance.ResultsUsing intention-to-treat analysis, CM produced higher utilization than SC of both pharmacotherapy (15.0% versus 2.5%; P = 0.108) and quitlines (12.5% versus 5.0%; P = 0.432), although differences were not statistically significant. Approval for pharmacotherapy assistance programs (20.0% versus 0.0%; P = 0.0005) was significantly higher for CM than SC participants. Self-reported point-prevalence smoking abstinence at 6-months were 20.0% and 17.5% for CM and SC, respectively (P = 0.775).ConclusionsCM holds promise as an effective intervention to connect Latino smokers to evidence-based cessation treatment.

scholarly journals Prevalence and predictors of Post-Acute COVID-19 Syndrome (PACS) after hospital discharge: A cohort study with 4 months median follow-up

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0260568
Author(s):  
Imad M. Tleyjeh ◽  
Basema Saddik ◽  
Nourah AlSwaidan ◽  
Ahmed AlAnazi ◽  
Rakhee K. Ramakrishnan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Emergency Room ◽  
Hospital Stay ◽  
Hospital Discharge ◽  
Post Discharge ◽  
Persistent Symptoms ◽  
Phone Calls ◽  
Increased Risk ◽  
Baseline Health

Background Post-acute COVID-19 syndrome (PACS) is an emerging healthcare burden. The risk factors associated with PACS remain largely unclear. The aim of this study was to evaluate the frequency of new or persistent symptoms in COVID-19 patients post hospital discharge and identify associated risk factors. Methods Our prospective cohort comprised of PCR-confirmed COVID-19 patients admitted to King Fahad Medical City, Riyadh, Saudi Arabia between May and July 2020. The patients were interviewed through phone calls by trained physicians from 6 weeks up to 6 months post hospital discharge. Multivariate Cox proportional hazards and logistic regression models were used to examine for predictors associated with persistence of symptoms and non-return to baseline health. Results 222 COVID-19 patients responded to follow-up phone interviews after a median of 122 days post discharge. The majority of patients were men (77%) with mean age of 52.47 (± 13.95) years. 56.3% of patients complained of persistent symptoms; 66 (29.7%) experiencing them for >21 days and 64 (28.8%) reporting not having returned to their baseline health. Furthermore, 39 patients (17.6%) reported visiting an emergency room post discharge for COVID-19-related symptoms while 16 (7.2%) had required re-hospitalization. Shortness of breath (40.1%), cough (27.5%) and fatigue (29.7%) were the most frequently reported symptoms at follow-up. After multivariable adjustments, female gender, pre-existing hypertension and length of hospital stay were associated with an increased risk of new or persistent symptoms. Age, pre-existing lung disease and emergency room visits increased the likelihood of not fully recovering from acute COVID-19. Patients who were treated with interferon β-1b based triple antiviral therapy during hospital stay were less likely to experience new or persistent symptoms and more likely to return to their baseline health. Conclusions COVID-19 survivors continued to suffer from dyspnea, cough and fatigue at 4 months post hospital discharge. Several risk factors could predict which patients are more likely to experience PACS and may benefit from individualized follow-up and rehabilitation programs.

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