A Computerized Aid to Support Smoking Cessation Treatment for Hospital Patients (original) (raw)
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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.
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
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.
Intervention study to improve smoking cessation during hospitalization
Public Health, 2011
Objectives: In France, hospitals have been smoke free since February 2007. A period of hospitalization may be a good time to enhance a smoker's motivation to quit. This study aimed to assess whether training medical staff in smoking cessation management might improve the rate of smoking cessation during hospitalization. Study design: Non-randomized intervention study. Methods: Staff of the participating care units either received (intervention group) or did not receive (control group) training in smoking cessation management. The dependent variable was the proportion of inpatients that continued to smoke before (Period 1) and after (Period 2) the training session. Results: In total, 358 patients were included. In Period 1, 55.6% and 50% of the smokers from the intervention and control groups stopped smoking, respectively; the corresponding rates in Period 2 were 64.3% and 48.1%. In Period 2, 36.4% and 31.8% of the smokers from the intervention and control groups claimed that they had received motivational counselling. In the intervention group, the request rate for nicotine replacement therapy (NRT) was higher (41.7%) compared with the control group (11.1%). In both groups, patients asked for NRT more often (P < 0.001) when they had received motivational counselling. Conclusions: This study was not able to demonstrate that training medical staff in smoking cessation management has a significant impact on smoking cessation in hospitalized smokers. The delivery of medium-intensity support to all smokers appears to be out of reach of physician/nurse teams. New strategies are needed, including a team specifically dedicated to the problems of addiction.
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...
Abstract Hospitalisation is an ideal time to implement smoking cessation interventions, and brief cessation advice from healthcare practitioners increase quit rates among hospitalised smokers. However, little is known about the extent inpatients receive such advice, or the impact it has on motivation to quit and quitting behaviours post-hospitalisation. This study aimed to determine the prevalence of smoking and cessation advice received by in-patients in two teaching hospitals in Ireland, and the impact of same 3-months post-discharge. Methods We surveyed 1001 in-patients across two hospital sites, over a six month period. Demographic details, clinical history, smoking history, motivation to quit, cigarette dependence and recent quitting history were assessed. Telephone follow-up at 3-months post-hospitalisation was used to establish post-discharge motivation to quit and establish smoking behaviours and quit attempts. A sample of self-reported quitters were asked to provide a breath sample using a carbon monoxide monitor (CO) to objectively assess smoking status at 3-months. Results Prevalence of smoking within the sample was 23.4% (235/1001). Only 32% (75/235) of smokers reported that smoking cessation was discussed during admission. Patient smoking status was documented in the records of 57% (132/235) of smokers. Smokers’ mean Fagerstrom nicotine dependence score was 3.7 (SD=2.7), indicating low dependence levels. At 3 months, 17% (25/146) of smokers reported smoking cessation, with 68% confirmed on CO test (17/25). Provision of smoking cessation advice during hospitalisation was associated with higher motivation to quit (OR=2.79, 95% CI 2.12-3.68), and successful quit behaviour (OR=2.02, 95% CI 1.34-3.06). Conclusions The current study finds that provision of brief cessation advice and smoking status documentation is suboptimal in two hospitals in Ireland. Where advice was given, it was associated with enhanced motivation to quit and increased quit rates. These findings, along with low average nicotine dependence scores in smokers, suggest that systematic provision of low-intensity cessation interventions could significantly enhance quit rates in hospitalised smokers.
Evidence Check: Smoking cessation care in hospitals
2016
This Sax Institute Evidence Check review examines models of managing nicotine dependence in health facilities under a smoke-free healthcare policy directive. The research evidence suggests that smoking cessation can be increased via a number of interventions including: smoking status assessment; provision of advice/counselling; nicotine replacement therapy; and referral for specialist follow-up. A number of clinical practice strategies, such as training, electronic reminders and leadership were found to be effective at increasing clinician provision of smoking cessation care. A review of best practice documents and initiatives implemented in Australasian jurisdictions identified a number of policies, frameworks, tools and services intended to support delivery of smoking cessation care.
Evaluation of a (pilot) stage-tailored brief smoking cessation intervention among hospital patients
Australian Health Review, 2000
Despite the significant benefits of advising all smokers to quit, hospital patients who smoke do not systematically receive this advice. This study sought to determine the prevalence of smoking, attitudes of patients towards not smoking while in hospital, and the feasibility and effectiveness of a brief smoking cessation intervention in a preadmission clinic context. Over 230 smokers received a brief smoking cessation intervention, while a control group (n=114) received only a free Quit Kit. The age-standardised smoking prevalence was 19%; a further 3% of patients were recent quitters. Most smokers do not expect or experience problems with not smoking while in hospital. Brief smoking cessation advice tailored to stage-of-change by a health worker in a hospital pre-admission clinic significantly increased the quit rates for females.
Despite the significant benefits of advising all smokers to quit, hospital patients who smoke do not systematically receive this advice. This study sought to determine the prevalence of smoking, attitudes of patients towards not smoking while in hospital, and the feasibility and effectiveness of a brief smoking cessation intervention in a preadmission clinic context. Over 230 smokers received a brief smoking cessation intervention, while a control group (n=114) received only a free Quit Kit. The age-standardised smoking prevalence was 19%; a further 3% of patients were recent quitters. Most smokers do not expect or experience problems with not smoking while in hospital. Brief smoking cessation advice tailored to stage-of-change by a health worker in a hospital pre-admission clinic significantly increased the quit rates for females.