scholarly journals Evaluating the utility of a Smoking Cessation Clinical Pathway tool to promote nicotine prescribing and use among inpatients of a tertiary hospital in Brisbane, Australia

2020 ◽  
Vol 15 (4) ◽  
pp. 214-218
Author(s):  
Keshia R. De Guzman ◽  
Centaine L. Snoswell ◽  
Cheneal Puljevic ◽  
Deepali Gupta

AbstractIntroductionDue to the burden of tobacco-related illnesses among hospital inpatients, an evidence-based smoking cessation brief intervention tool was developed for clinicians working in hospitals in Queensland, Australia. The tool, called the Smoking Cessation Clinical Pathway (SCCP), is used by clinicians to support inpatient smoking cessation and manage nicotine withdrawal in hospital.AimsTo investigate the impact of completed SCCP on nicotine replacement therapy (NRT) prescribing and use, and to explore clinician involvement in smoking cessation interventions.MethodsA retrospective review was conducted to examine data regarding SCCP responses and NRT offering, prescribing and use. The statistical significance of the results was assessed using chi-squared and Fisher's exact tests.ResultsPatients with a completed SCCP were more likely to be offered NRT (P < 0.0001). NRT prescribing on admission and discharge was higher in patients with a completed SCCP (P = 0.001 and P = 0.027). Intention to quit had no effect on whether NRT was offered (P = 0.276) and NRT acceptance was higher for patients that intended to quit smoking (P < 0.0001).ConclusionsThe SCCP prompted clinicians to offer NRT to patients, leading to increased NRT prescribing and use. These findings demonstrate the utility of the SCCP to assist clinicians to promote smoking cessation among hospital inpatients.

2021 ◽  
Vol 9 ◽  
Author(s):  
Yina Hu ◽  
Jianghua Xie ◽  
Xiaochang Chang ◽  
Jianhua Chen ◽  
Wei Wang ◽  
...  

Background: More than 300 million smokers make China the largest cigarette consumer globally, which is a huge economic burden. Smoking cessation (SC) clinics can offer counseling and follow-up services. The operational experience of SC clinics in China needs to be summarized and improved based on research evidence.Purpose: The objectives of this study were to describe quit rates among attendees of SC clinics in Hunan and assess predictors of successful SC.Methods: The participants in this study were smokers who visited the SC clinic of Hunan Cancer Hospital from February 1, 2015 to September 30, 2018. Individuals who received individual counseling and assessment from the SC clinic staff and were willing to quit smoking were eligible for inclusion. Those with critical illness or cancer were excluded. Application of smoking cessation clinic registration form (unified by Chinese Center for Disease Control and Prevention) was used to assess participants at the consultation. Follow-ups and counseling were performed over telephone at 1 week, 1 month, and 3 months after the initial cessation consultation or in times of need. Successful SC was checked for at 3 months after the start of SC.Results: A total of 328 smokers (mean age 45.67 ± 12.38 years) had participated. The abstinence rate at 3 months was 28.4%. Binary regression analysis revealed significant independent predictors to be the total numbers of SC follow up sessions, previous SC attempts, and participants' decision on when to quit smoking (The relative to quit immediately group, quit within 30 days, quit after 30 days, and undecided quit were less likely to succeed in quitting. while quit within seven days had no statistical significance.Conclusion: SC clinics can achieve a desirably high quit rate. Participant's previous attempts at quitting, three or more follow-ups, and the decision to quit immediately or within seven days were factors helpful in predicting the success of SC.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tessa Scheffers-van Schayck ◽  
Bethany Hipple Walters ◽  
Roy Otten ◽  
Marloes Kleinjan

Abstract Background Recently, the parent-tailored telephone based smoking cessation counseling program ‘Smoke-free Parents’ was shown to be effective in helping parents to quit smoking. To implement this program in child healthcare settings in the Netherlands, the research team developed a proactive referral tool to refer parents to Smoke-free Parents. The aim of the present implementation study was to explore the facilitators, barriers, and suggestions for improvement in the implementation of this referral tool. Methods Child healthcare professionals (N = 68) were recruited via multiple strategies (e.g., social media, mailings, and word of mouth among healthcare professionals) and invited to complete two online (quantitative and qualitative) questionnaires and to participate in a telephone semi-structured qualitative interview between April 2017 and February 2019. In total, 65 child healthcare professionals were included in the analyses. After inductive coding, thematic analyses were performed on the qualitative data. Descriptive analyses were performed on the quantitative data. Results The data from both questionnaires and the telephone interview revealed that the majority of the child healthcare professionals (92.3 % female; average years of working as a healthcare professional: 23.0) found the Smoke-free Parents referral tool accessible and convenient to use. Yet there were several barriers that limited their use of the tool. The data revealed that one of the main barriers that healthcare professionals experienced was parental resistance to smoking cessation assistance. In addition, healthcare professionals noted that they experienced tension when motivating parents to quit smoking, as they were not the parent’s, but the child’s healthcare provider. Additionally, healthcare professionals reported being concerned about the lack of information about the costs of Smoke-free Parents, which limited professionals referring parents to the service. Conclusions Although healthcare professionals reported rather positive experiences with the Smoke-free Parents referral tool, the use of the tool was limited due to barriers. To increase the impact of the Smoke-free Parents telephone-based smoking cessation counseling program via child healthcare settings, it is important to overcome these barriers. Suggestions for improvement in the implementation of the referral tool in child healthcare settings are discussed.


Author(s):  
Rosa Méndez ◽  
Angels Figuerola ◽  
Marta Chicot ◽  
Ana Barrios ◽  
Natalia Pascual ◽  
...  

Background. In the hospital of La Princesa, the “Sepsis Code” (CSP) began in 2015, as a multidisciplinary group that provides health personnel with clinical, analytical and organizational tools, with the aim of the detection and early treatment of patients with sepsis. The objective of this study is to evaluate the impact of CSP implantation on mortality and to determine the variables associated with an increase in it. Material and methods. A retrospective analytical study of patients with CSP alert activation from 2015 to 2018 was conducted. Clinical-epidemiological variables, analytical parameters, and severity factors such as admission to critical care units (UCC) and the need for amines were collected. Statistical significance was established at p < 0.05. Results. We included 1,121 patients. The length of stay was 16 days and 32% required admission to UCC. Mortality showed a statistically significant linear downward trend from 24% in 2015 to 15% in 2018. The predictive mortality variables with statistically significant association were lactate > 2 mmol/L, creatinine > 1.6 mg/dL and the need for amines. Conclusions. The implementation of Sepsis Code decreases the mortality of patients with sepsis and septic shock. The presence of a lactate > 2 mmol/L, creatinine > 1.6 mg/dL and/or the need to administer amines in the first 24 hours, are associated with an increase in mortality in the patient with sepsis.


2020 ◽  
Vol 13 ◽  
pp. 1179173X2096306
Author(s):  
Tove Sohlberg ◽  
Karin Helmersson Bergmark

Background: Since smoking is the leading cause of preventable death, discouraging smoking initiation, encouraging smoking cessation, and exploring factors that help individuals to stay smoke free are immensely important. One such relevant factor may be the impact of lifestyle for long-term smoking cessation. Method: A representative sample of successful quitters was recruited for a study about smoking cessation. These respondents are now part of a 7-year follow-up with the overall aim of revealing factors affecting long-term smoking cessation. Descriptive analyses were carried out at baseline and at follow-up, as well as a further two-step cluster analysis to explore profiles of long-term smoke-free individuals. Results: A majority did not make any particular lifestyle changes, but among those who did, most adopted a healthier lifestyle and/or increased their quota of physical training, where permanent changes in this direction seem to promote a more enduring smoke-free life. Conclusions: Individuals who want to quit smoking should be encouraged to increase their level of physical activity. Swedish health care institutions should be able to provide support for this both initially and over time to promote the long-term maintenance of a smoke-free lifestyle.


Author(s):  
Laurie Long Kwan Ho ◽  
William Ho Cheung Li ◽  
Ankie Tan Cheung ◽  
Wei Xia ◽  
Man Ping Wang ◽  
...  

Tobacco use is a possible risk factor for contracting and spreading COVID-19. We aimed to describe the impact of the COVID-19 pandemic on the Youth Quitline service and quitting behaviors of its users in Hong Kong. We conducted a telephone survey involving 201 participants of the Youth Quitline service, and retrospectively analyzed the operation and use of Quitline since the COVID-19 outbreak in Hong Kong. The number of incoming calls to the Youth Quitline and the participants′ quit rate has increased since the COVID-19 outbreak in Hong Kong. Many participants (68%) did not realize that tobacco use potentially increased their risk for developing and spreading COVID-19; however, 43% agreed that the pandemic motivated their intention to quit, and 83% changed their smoking habits during the pandemic. These changes were mainly due to wearing masks (30%), closure of bars/pubs (25%), suspension of classes (14%), and being unable to socialize with friends (24%). Overall, 58% reduced their tobacco use; of these participants, 66% reported a ≥50% reduction in daily cigarette consumption. The participants reduced their smoking during the COVID-19 pandemic despite lacking knowledge about the potentially increased risk for contracting COVID-19 from continued smoking. The pandemic could create new opportunities to motivate young smokers to quit smoking, especially those seeking support for smoking cessation, and may further contribute to reducing the risks posed by COVID-19.


2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 1012-1012
Author(s):  
C. D. Figueroa-Moseley ◽  
G. C. Williams ◽  
G. R. Morrow ◽  
P. Jean-Pierre ◽  
J. Carroll ◽  
...  

1012 Background: Few studies have examined the potential influence of an empowering Self Determination Theory (SDT) intervention on reducing smoking behaviors and outcomes for Whites and Blacks. Objectives: To determine if empowerment to stop smoking is associated with smoking outcomes in Whites and Blacks, and to examine if empowerment to stop smoking improved under the SDT Intervention vs. Usual Care conditions. Methods: A longitudinal randomized trial study was conducted to examine the effect of a SDT and health behavior change intervention for tobacco cessation among adult smokers. Participants were randomized into the SDT Intervention or the Usual Care condition. The present study includes data from a sample of 821 Whites and 177 Blacks who completed anonymous surveys at 1, 6, and 18-months intervals on empowerment to stop smoking (Perceived Competence Scale, Treatment Self-Regulation Questionnaire), demographics, and smoking behaviors. Results: Stepwise logistic regressions showed that empowerment to stop smoking was associated with quitting smoking at 1, 6, and 18 month follow-up for both treatment conditions. At one month, participants in the SDT Intervention with the highest levels of empowerment were 6.3 times more likely to quit smoking as compared with those in the usual care condition who were only 3.15 times as likely to quit smoking. Similar findings were found at 6 months and at 18 months (6- month SDT Intervention Empowerment High: (OR = 8.66, 95% C.I. 4.6, 16.3); 6 month Usual Care Empowerment High: (OR = 3.10, 95% C.I. 1.4, 7.0); 18- month SDT Intervention Empowerment High: (OR = 4.10, 95% C.I. 2.2, 7.5); 18 month Usual Care Empowerment High: (OR = 3.11, 95% C.I. 1.3, 7.7). In the SDT Intervention at 6 months being Black increased successful quitting by 2.4 times. Conclusions: Findings indicate that at each time-point the SDT Intervention empowered more participants to stop smoking than usual care alone. Findings also suggest that Blacks may increase their ability to stop smoking in the SDT Intervention condition. These preliminary findings highlight the need to further investigate the possible roles of empowerment interventions in smoking cessation among Whites and Blacks, especially cancer patients. No significant financial relationships to disclose.


2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Zainab Samaan ◽  
Barb Nowacki ◽  
Karleen Schulze ◽  
Patrick Magloire ◽  
Sonia S. Anand

Introduction. Smoking is a leading cause of morbidity and mortality globally and it is a significant modifiable risk factor for cardiovascular disease (CVD) and other chronic diseases. Efforts to encourage and support smokers to quit are critical to prevent premature smoking-associated morbidity and mortality. Hospital settings are seldom equipped to help patients to quit smoking thus missing out a valuable opportunity to support patients at risk of smoking complications. We report the impact of a smoking cessation clinic we have established in a tertiary care hospital setting to serve patients with CVD. Methods. Patients received behavioural and pharmacological treatments and were followed up for a minimum of 6 months (mean 541 days, SD 197 days). The main study outcome is ≥50% reduction in number of cigarettes smoked at followup. Results. One hundred and eighty-six patients completed ≥6 months followup. More than half of the patients (52.7%) achieved ≥50% smoking reduction at follow up. Establishment of a plan to quit smoking and use of nicotine replacement therapy (NRT) were significantly associated with smoking reduction at followup. Conclusions. A hospital-based smoking cessation clinic is a beneficial intervention to bring about smoking reduction in approximately half of the patients.


2020 ◽  
Vol 14 (4) ◽  
pp. 245-251 ◽  
Author(s):  
Fui Lin Wong ◽  
Georgia Antoniou ◽  
Nicole Williams ◽  
Peter J. Cundy

Purpose This study was designed to evaluate the impact of the COVID-19 pandemic on paediatric orthopaedic services in a paediatric tertiary hospital in South Australia. Methods A retrospective audit was conducted of orthopaedic activity at a major paediatric tertiary hospital with a Level 1 paediatric trauma centre, where no patients were admitted with COVID-19 illness. Orthopaedic Emergency Department (ED) presentations, outpatient clinics and hospital admissions for the period between 16 March 2020 to 26 April 2020 were studied and compared with the same period in 2019 (18 March 2019 to 28 April 2019). Chi-square tests were performed with p < 0.05 indicating statistical significance. Results In total, 621 patients presented to the ED with orthopaedic complaints during the pandemic (versus 997 in 2019). However, there was minimal change in the number of ED presentations requiring admission (110 in 2020 versus 116 in 2019). Among patients discharged directly from ED, 27.3% received hospital outpatient referral (versus 39.1% in 2019), with the remaining patients referred to community health services or discharged directly. There was a 509.8% increase in telehealth (video and phone) outpatient consultations compared to 2019 and a 60.6% decline in face-to-face appointments. There was a total of 144 orthopaedic admissions (elective and emergency) compared to 184 in 2019. Admissions for children under seven remained unchanged (32.5% reduction in children aged seven and above). Conclusion Despite an overall decline in all paediatric orthopaedic hospital activity, the number of emergency admissions for musculoskeletal conditions did not change. Elective surgery numbers for children aged under seven were also unchanged. Appropriate planning and hospital resources allocation are necessary to meet this service requirement in future pandemics. Level of evidence IV


2019 ◽  
Author(s):  
Hsien-Liang Huang ◽  
Yun-Cheng Tsai ◽  
Shi-Hao Hong ◽  
Ya-Mei Hsueh

BACKGROUND Smoking is a complex behavior associated with multiple factors such as personality, environment, genetics, and emotions. Text data is a rich source of information. However, pure text data requires substantial human resources and time to extract and apply the information, resulting in many details not being discovered and used. OBJECTIVE This study proposes a novel approach that explores a text mining flow to capture the behavior of smokers quitting tobacco from their free-text medical records. More importantly, the paper explores the impact of these changes on smokers. The goal is to help smokers quit smoking. Therefore, the paper develops an algorithm for analyzing smoking cessation treatment plans documented in free-text medical records. METHODS The approach involves the development of an information extraction flow that uses a combination of data mining techniques, including text mining. It can be used not only to help others quit smoking but also for other medical records with similar data elements. RESULTS In the paper, the most visible areas for the medical application of text mining are the integration and transfer of advances made in basic sciences, as well as a better understanding of the processes involved in smoking cessation. CONCLUSIONS Text mining may also be useful for supporting decision-making processes associated with smoking cessation.


2017 ◽  
Vol 45 (2) ◽  
pp. 181-189 ◽  
Author(s):  
Taghrid Asfar ◽  
David J. Lee ◽  
Byron L. Lam ◽  
Ann P. Murchison ◽  
Eileen L. Mayro ◽  
...  

Background. Smoking causes blindness-related diseases. Eye-care providers are uniquely positioned to help their patients quit smoking. Aims. Using a pre-/postevaluation design, this study evaluated a web-based training in smoking cessation counseling targeting eye-care providers. Method. The training was developed based on the 3A1R protocol: “Ask about smoking, Advise to quit, Assess willingness to quit, and Refer to tobacco quitlines,” and made available in the form of a web-based video presentation. Providers ( n = 654) at four academic centers were invited to participate. Participants completed pretraining, posttraining, and 3-month follow-up surveys. Main outcomes were self-reported improvement in their motivation, confidence, and counseling practices at 3-month follow-up. Generalized linear mixed models for two time-points (pretraining and 3-month) were conducted for these outcomes. Results. A total of 113 providers (54.0% males) participated in the study (17.7% response rate). At the 3-month evaluation, 9.8% of participants reported improvement in their motivation. With respect to the 3A1R, 8% reported improvement in their confidence for Ask, 15.5% for Advise, 28.6% for Assess, and 37.8% for Refer. Similarly, 25.5% reported improvement in their practices for Ask, 25.5% for Advise, 37.2% for Assess, and 39.4% for Refer to tobacco quitlines ( p < .001 for all except for Refer confidence p = .05). Discussion. Although participation rate was low, the program effectively improved providers’ smoking cessation counseling practices. Conclusions. Including training in smoking cessation counseling in ophthalmology curriculums, and integrating the 3A1R protocol into the electronic medical records systems in eye-care settings, might promote smoking cessation practices in these settings.


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