Tabagismo em idosos

Introdução: o tabagismo é um grave problema de saúde pública em âmbito mundial que afeta a todas as faixas etárias, causando altas taxas de morbimortalidade evitáveis.Objetivo: descrever o que vem sendo publicado sobre o tabagismo na população idosa nos últimos cinco anos na esfera internacional.Metodologia: trata-se de uma revisão integrativa da literatura, onde foram realizadas buscas de artigos nas seguintes bases de dados: PUBMED/MEDLINE, BVS/LILACS, SCOPUS e SCIELO, utilizando os seguintes Descritores em Ciências da Saúde em inglês: “Tobacco Use Cessation” OR “Tobacco Use Disorder” AND “Health of the Elderly” OR “Aged” OR “Aged, 80 and over”. O recorte temporal foi de 2016 a 2020.Resultados: dos 1.642 trabalhos recuperados das bases, houve o afunilamento para um número total de 18 artigos, com a seguinte categorização: mortalidade e outros desfechos clínicos negativos (5); o tabagismo, as síndromes geriátricas e outras patologias (4); políticas públicas para o controle do tabaco (3); qualidade de vida e tabagismo (3); e fatores preditores para cessação tabágica (3).Conclusões: apenas um estudo selecionado foi realizado no Brasil, ressaltando a necessidade de mais estudos brasileiros envolvendo o tabagismo na população idosa objetivando uma melhor compreensão dos aspectos envolvidos e futuras capacitações e otimização de políticas públicas específicas.

How to create public health Facebook posts based on Motivational Interviewing a pproach ?

Objective: This research aimed at identifying which types of social media content could achieve higher engagement rate and encourage smokers' motivational language. Intervention contents were classified according to motivational interviewing (MI) strategies. Methods: We categorized the included 701 Facebook posts (N=701) into five different groups according to specific MI strategies. Entertaining and informative strategies were in the control group. Facebook users’ interactions were the primary outcomes (engagement rate, negative feedback, and fan-total reach ratio). The comments reflecting smokers’ motivational language were the secondary outcomes (change talk and sustain talk). Results:MI strategies achieved significantly higher engagement rate, higher fan-total reach ratio, and evoked more change talk. “Elaborating change talk” strategies elicited considerably more change talk. “Affirming change talk” strategies obtained higher fan-total reach ratio and generated significantly more change talk. “Relational MI” strategies achieved significantly higher engagement rate. Conclusions: This study offers an important insight into the Facebook post creating for public health professionals who design Facebook-based interventions. These MI strategies can increase the engagement rate: ”Building Partnership” and ”Expressing Empathy”. These MI strategies can reach more fans: ”Affirming Change Talk” and ”Reflecting Change Talk” strategies. Finally, these MI strategies can support smoking cessation: ”Elaborating Change Talk” and ”Affirming Change Talk” strategies. Source: Pócs D, Óvári T, Watti J, Hamvai Cs, Kelemen O. How to create social media contents based on Motivational Interviewing approach to support tobacco use cessation? A content analysis. Journal of Substance Use 2021; DOI: 10.1080/14659891.2021.1967484. [Full preprint with appendix is available at ResearchGate.]

Health workers’ perceptions on where and how to integrate tobacco use cessation services into tuberculosis treatment; a qualitative exploratory study in Uganda

Background Tobacco use is associated with exacerbation of tuberculosis (TB) and poor TB treatment outcomes. Integrating tobacco use cessation within TB treatment could improve healing among TB patients. The aim was to explore perceptions of health workers on where and how to integrate tobacco use cessation services into TB treatment programs in Uganda. Methods Between March and April 2019, nine focus group discussions (FGDs) and eight key informant interviews were conducted among health workers attending to patients with tuberculosis on a routine basis in nine facilities from the central, eastern, northern and western parts of Uganda. These facilities were high volume health centres, general hospitals and referral hospitals. The FGD sessions and interviews were tape recorded, transcribed verbatim and analysed using content analysis and the Chronic Care Model as a framework. Results Respondents highlighted that just like TB prevention starts in the community and TB treatment goes beyond health facility stay, integration of tobacco cessation should be started when people are still healthy and extended to those who have been healed as they go back to communities. There was need to coordinate with different organizations like peers, the media and TB treatment supporters. TB patients needed regular follow up and self-management support for both TB and tobacco cessation. Patients needed to be empowered to know their condition and their caretakers needed to be involved. Effective referral between primary health facilities and specialist facilities was needed. Clinical information systems should identify relevant people for proactive care and follow up. In order to achieve effective integration, the health system needed to be strengthened especially health worker training and provision of more space in some of the facilities. Conclusions Tobacco cessation activities should be provided in a continuum starting in the community before the TB patients get to hospital, during the patients’ interface with hospital treatment and be given in the community after TB patients have been discharged. This requires collaboration between those who carry out health education in communities, the TB treatment supporters and the health workers who treat patients in health facilities.

Association of heated tobacco product use with tobacco use cessation in a Japanese workplace: a prospective study

We investigated how use of heated tobacco products (HTPs) affects tobacco cessation in a Japanese workplace. We offered cessation programmes for 158 tobacco users from November 2018 to April 2019 and surveyed the quitting rate in August 2019. Successful quitting was defined as stopping use of all kinds of nicotine-containing tobacco products. A Poisson regression analysis adjusted with inverse probability weighting showed that HTP users (either exclusive HTP users or dual users) were less likely than exclusive cigarette users to quit tobacco (risk ratio, 0.77; 95% CIs 0.61 to 0.97, p=0.024). The use of HTPs should not be recommended to assist in smoking cessation. Trial registration UMIN000034719.

Implementation of the Quality Oncology Practice Initiative Program in Spain: First Results and Implications

PURPOSE: Measuring and tracking quality of care is highly relevant in today's health care. The Quality Oncology Practice Initiative (QOPI) program is a referral for evaluating oncology practices worldwide. Excellence and Quality in Oncology Foundation, a collaboration of oncology experts from major Spanish hospitals involved in cancer treatment, reached an agreement with QOPI to include Spanish hospitals in this program. METHODS: We analyzed the results of the QOPI Core module measures from 19 Spanish hospitals over nine rounds (from fall 2015 to fall 2019). RESULTS: Of the 19 hospitals, 15 completed more than one round; none participated in all nine (two hospitals participated in eight rounds). The highest scores were for pathology report confirming malignancy, documenting a plan of care for moderate or severe pain and chemotherapy dose, and chemotherapy administered to patients with metastatic solid tumor with performance status undocumented. Measures regarding a summary of chemotherapy treatment, tobacco use cessation counseling, and assessment of patient emotional well-being were among the lowest scored measures. Six of the 15 practices that participated repeatedly achieved a better score in their last round compared with their first. Overall, scores of Spanish hospitals improved from 67.79% in fall 2015 to 68.91% in fall 2019. CONCLUSION: To our knowledge, this is the first study to evaluate QOPI scores in Spain. There was high variability in scores, with quality of care improving with repeated participation in some hospitals, but worsening in others. Excellence and Quality in Oncology Foundation will support practices to increase their participation to improve oncology care and implement strategies that address the areas for improvement.

Evaluation of Spanish hospitals participating in the Quality Oncology Practice Initiative program.

222 Background: Measuring and tracking quality of care is highly relevant in today’s healthcare. The Quality Oncology Practice Initiative (QOPI) program is a referral for evaluating oncology practices worldwide. The ECO Foundation (Excellence and Quality in Oncology), a collaboration of oncology experts from the major Spanish hospitals involved in cancer treatment, reached an agreement with ASCO (American Society of Clinical Oncology) to include Spanish hospitals in its QOPI program. Methods: We analyzed the results of the QOPI core module measures from 19 Spanish hospitals submitting their data in nine rounds (from Fall 2015 to Fall 2019). Results: Of the 19 hospitals, 15 participated more than once; none participated in all 9 rounds (2 hospitals participated in 8 rounds). The highest scores were for pathology report confirming malignancy, documenting plan of care for moderate/severe pain and chemotherapy dose, and chemotherapy administered to patients with metastatic solid tumor with performance status undocumented. Measures regarding a summary of chemotherapy treatment, tobacco use cessation counseling, and assessment of patient emotional well-being were among the lowest scored measures. Six of the 15 practices who participated repeatedly achieved a better score in their last round compared to their first. Overall, scores of Spanish hospitals improved from 67.79% in Fall 2015 to 68.91% in Fall 2019. Conclusions: This is the first study to evaluate QOPI scores in Spain; it showed that repeated participation enhances quality of care, although there is room for improvement. The ECO Foundation will continue supporting and engaging with practices to increase their participation in order to improve oncology care and implement strategies that address the areas for improvement.

Health Workers’ Perceptions on Where and How to Integrate Tobacco use Cessation Services into Tuberculosis Treatment; A Qualitative Exploratory Study in Uganda

Background: Tobacco use is associated with exacerbation of tuberculosis (TB) and poor TB treatment outcomes. Integrating tobacco use cessation within TB treatment could improve healing among TB patients. The aim was to explore perceptions of health workers on where and how to integrate tobacco use cessation services into TB treatment programs in Uganda.Methods: Between March and April 2019, nine focus group discussions (FGDs) and eight key informant interviews were conducted among health workers attending to patients with tuberculosis on a routine basis in nine facilities from the central, eastern, northern and western parts of Uganda. These facilities were high volume health centres, general hospitals and referral hospitals. The FGD sessions and interviews were tape recorded, transcribed verbatim and analysed using content analysis to identify themes.Results: Participants indicated that tobacco use cessation activities should be integrated in TB treatment starting from communities when people are still healthy. Cessation should also be implemented in health facilities including referral facilities, and be extended to those who have been healed as they go back to communities. This calls for collaborations beyond health workers to TB treatment supporters, peers and the media. Conclusions: Tobacco use cessation should take place in communities as well as health facilities. Partnerships with media and families are needed. Health system challenges need to be addressed to support effective implementation.