Health and economic effects from linking bedside and outpatient tobacco cessation services for hospitalized smokers in two large hospitals: study protocol for a randomized controlled trial (original) (raw)
Related papers
Trials, 2012
Background: A hospital admission offers smokers an opportunity to quit. Smoking cessation counseling provided in the hospital is effective, but only if it continues for more than one month after discharge. Providing smoking cessation medication at discharge may add benefit to counseling. A major barrier to translating this research into clinical practice is sustaining treatment during the transition to outpatient care. An evidence-based, practical, cost-effective model that facilitates the continuation of tobacco treatment after discharge is needed. This paper describes the design of a comparative effectiveness trial testing a hospital-initiated intervention against standard care.
A Post-Discharge Smoking-Cessation Intervention for Hospital Patients
American Journal of Preventive Medicine, 2016
Introduction-Hospitalization provides an opportunity for smokers to quit, but tobaccocessation interventions started in hospital must continue after discharge to be effective. This study aimed to improve the scalability of a proven effective post-discharge intervention by incorporating referral to a telephone quitline, a nationally available cessation resource. Study design-A three-site RCT compared Sustained Care, a post-discharge tobacco-cessation intervention, with Standard Care among hospitalized adult smokers who wanted to quit smoking and received in-hospital tobacco-cessation counseling.
Referring Hospitalized Smokers to Outpatient Quit Services: A Randomized Trial
American journal of preventive medicine, 2016
Linking outpatient cessation services to bedside counseling for hospitalized smokers can improve long-run quit rates. Adding an assisted referral (AR) offer to a tobacco treatment specialist consult service fits the team approach to care in U.S. hospitals. A two-arm patient-randomized trial tested the effectiveness of adding an AR offer to outpatient smoking-cessation services and interactive voice recognition (AR+IVR) follow-up to a usual care (UC) tobacco-cessation consult for hospitalized smokers. Over 24 months (November 2011-November 2013), 898 hospitalized adult smokers interested in quitting smoking were recruited from three large hospitals in the Portland, Oregon, area: an integrated group model HMO (n=622), a community hospital (n=195), and an academic health center (n=81). Tobacco treatment specialists identified smokers and provided an intensive bedside tobacco use assessment and cessation consultation (UC). AR+IVR recipients also received proactive ARs to available outpa...
Increasing smoking cessation care provision in hospitals: A meta-analysis of intervention effect
Nicotine & Tobacco Research, 2009
The review found that interventions could be moderately effective in increasing routine provision of assistance and counselling to stop smoking for hospital patients. Potential for missed studies and the heterogeneous evidence mean the authors' conclusions should be interpreted with caution. Authors' objectives To evaluate the effectiveness of controlled intervention studies in increasing the routine provision of smoking cessation in hospitals. Searching MEDLINE, EMBASE, CINAHL and PsycINFO were searched from January 1994 to June 2007 for publications in English; search terms were reported. The bibliography of each retrieved article was handsearched. Only articles with abstracts that could be checked were searched. Dissertations were excluded. Research: The authors stated that future research should endeavour to use stronger study designs to examine hospitalwide provision of a broader range of smoking cessation care practices, particularly nicotine replacement therapy and follow-up or referral to further quitting assistance. Such research would be strengthened by improved reporting of
A before-after implementation trial of smoking cessation guidelines in hospitalized veterans
Implementation Science, 2009
Background: Although most hospitalized smokers receive some form of cessation counseling during hospitalization, few receive outpatient cessation counseling and/or pharmacotherapy following discharge, which are key factors associated with long-term cessation. US Department of Veterans Affairs (VA) hospitals are challenged to find resources to implement and maintain the kind of high intensity cessation programs that have been shown to be effective in research studies. Few studies have applied the Chronic Care Model (CCM) to improve inpatient smoking cessation.
Smoking Cessation After Hospital Discharge: Factors Associated With Abstinence
Journal of hospital medicine, 2018
Hospitalization offers tobacco smokers an opportunity to quit smoking, but factors associated with abstinence from tobacco after hospital discharge are poorly understood. We analyzed data from a multisite, randomized controlled trial testin a smoking cessation intervention for 1,357 hospitalized cigaretts smokers who planned to quit. Using multiple logistic regression, we assessed factors identifiable in the hospital that were independently associated with biochemically confirmed tobacco abstinence 6 months after discharge. Biochemically confirmed abstinence at 6 months (n = 218, 16%) was associated with a smoking-related primary discharge diagnosis (Adjusted Odds Ratio [AOR] = 1.98, 95% CI: 1.41-2.77), greater confidence in the ability to quit smoking (AOR - 1.31, 95% CI: 1.07-1.60), and stronger intention to quit (plan to quit after discharge vs. try to quit; AOR = 1.68, CI: 1.19-2.38). In conclusion, smokers hospitalized with a tobacco-related illness and those with greater confi...
Trials, 2012
Nicotine patches and quitline counseling to help hospitalized smokers stay quit: Study protocol for a randomized controlled trial Permalink https://escholarship.org/uc/item/6c00n0bg Journal Trials,(1) Abstract Background: Hospitalized smokers often quit smoking, voluntarily or involuntarily; most relapse soon after discharge. Extended follow-up counseling can help prevent relapse. However, it is difficult for hospitals to provide follow-up and smokers rarely leave the hospital with quitting aids (for example, nicotine patches). This study aims to test a practical model in which hospitals work with a state cessation quitline. Hospital staff briefly intervene with smokers at bedside and refer them to the quitline. Depending on assigned condition, smokers may receive nicotine patches at discharge or extended quitline telephone counseling post-discharge. This project establishes a practical model that lends itself to broader dissemination, while testing the effectiveness of the interventions in a rigorous randomized trial. Methods/design: This randomized clinical trial (N = 1,640) tests the effect of two interventions on long-term quit rates of hospitalized smokers in a 2 x 2 factorial design. The interventions are (1) nicotine patches (eight-week, step down program) dispensed at discharge and (2) proactive telephone counseling provided by the state quitline after discharge. Subjects are randomly assigned into: usual care, nicotine patches, telephone counseling, or both patches and counseling. It is hypothesized that patches and counseling have independent effects and their combined effect is greater than either alone. The primary outcome measure is thirty-day abstinence at six months; a secondary outcome is biochemically validated smoking status. Cost-effectiveness analysis is conducted to compare each intervention condition (patch alone, counseling alone, and combined interventions) against the usual care condition. Further, this study examines whether smokers' medical diagnosis is a moderator of treatment effect. Generalized linear (binomial) mixed models will be used to study the effect of treatment on abstinence rates. Clustering is accounted for with hospital-specific random effects.
Addiction Science & Clinical Practice
BackgroundA cessation program for hospitalized smokers is an effective strategy to achieve smoking abstinence. The effects of multiple in-hospital counseling sessions on 6-month smoking abstinence require further investigation.MethodsWe retrospectively analyzed the data of smokers who participated in hospital-initiated cessation programs at a medical center between 2017 and 2019. Data on age, sex, comorbidities, daily number of cigarettes, cessation motivation, nicotine dependence, cessation medications, discharge diagnosis, length of hospitalization, and intensive care unit admission were collected. We conducted multiple logistic regression analysis to investigate the effect of multiple in-hospital counseling sessions on 6-month sustained smoking abstinence. Sensitivity analyses were carried out excluding participants who underwent post-discharge cessation programs and assuming that the loss to follow-up participants had failure in 6-month smoking abstinence.ResultsA total of 1943 ...
In-hospital smoking cessation programs: what do VA patients and staff want and need?
Applied Nursing Research, 2008
In preparation for delivering an inpatient smoking cessation intervention, surveys and interviews of general inpatients and staff were conducted in two Veterans Affairs (VA) hospitals to determine the motivation of veterans to quit smoking and to identify facilitators and barriers to inpatient staff delivery of inpatient cessation services. Seventy percent of inpatients were bmotivated smokersQ (thinking of quitting in the next 30 days), yet only 17% stated that they received cessation services during their hospitalization. Most staff said that VA should do more to assist patients to quit, yet less than half said that they personally provided cessation services due to lack of confidence/training and hesitancy to upset patients. Given the high motivation to quit among hospitalized veterans and the lack of knowledge about providing cessation services among nurses, training health professionals may facilitate and overcome barriers to the provision of these services. As frontline providers, nurses are ideally positioned to deliver inpatient smoking cessation services to hospitalized veterans. D