Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-19T09:22:58.114Z Has data issue: false hasContentIssue false

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

Published online by Cambridge University Press:  03 September 2020

Keshia R. De Guzman*
Affiliation:
Centre for Health Services Research, The University of Queensland, Brisbane, Australia Pharmacy Department, Princess Alexandra Hospital, Brisbane, Australia School of Public Health, The University of Queensland, Brisbane, Australia
Centaine L. Snoswell
Affiliation:
Centre for Health Services Research, The University of Queensland, Brisbane, Australia Pharmacy Department, Princess Alexandra Hospital, Brisbane, Australia School of Pharmacy, The University of Queensland, Brisbane, Australia
Cheneal Puljevic
Affiliation:
Centre for Health Services Research, The University of Queensland, Brisbane, Australia School of Public Health, The University of Queensland, Brisbane, Australia
Deepali Gupta
Affiliation:
Pharmacy Department, QE2 Jubilee Hospital, Brisbane, Australia Statewide Respiratory Clinical Network, Clinical Excellence Division, Queensland Health, Brisbane, Australia
*
Author for correspondence: Keshia R. De Guzman, E-mail: keshia.deguzman@uq.net.au

Abstract

Introduction

Due 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.

Aims

To investigate the impact of completed SCCP on nicotine replacement therapy (NRT) prescribing and use, and to explore clinician involvement in smoking cessation interventions.

Methods

A 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.

Results

Patients 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).

Conclusions

The 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.

Type
Brief Report
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Australian Institute of Health and Welfare. (2020). Alcohol, tobacco & other drugs in Australia. Retrieved from https://www.aihw.gov.au/reports/alcohol/alcohol-tobacco-other-drugs-australia/contents/drug-types/tobaccoGoogle Scholar
Department of Health (2017). Burden of disease and injury: Summary results for Queensland. Brisbane: Queensland Government.Google Scholar
Department of Health. (2019). How to quit smoking. Retrieved from https://www.health.gov.au/health-topics/smoking-and-tobacco/how-to-quit-smokingGoogle Scholar
Fiore, M. C., & Jaen, C. R. (2008). A clinical blueprint to accelerate the elimination of tobacco use. JAMA, 299(17), 20832085. doi: 10.1001/jama.299.17.2083CrossRefGoogle ScholarPubMed
Freund, M., Campbell, E., Paul, C., McElduff, P., Walsh, R. A., Sakrouge, R., … Knight, J. (2008). Smoking care provision in hospitals: A review of prevalence. Nicotine & Tobacco Research, 10(5), 757774. doi: 10.1080/14622200802027131CrossRefGoogle Scholar
Fung, P. R., Snape-Jenkinson, S. L., Godfrey, M. T., Love, K. W., Zimmerman, P. V., Yang, I. A., & Fong, K. M. (2005). Effectiveness of hospital-based smoking cessation. Chest, 128, 216223. https://doi.org/10.1378/chest.128.1.216CrossRefGoogle ScholarPubMed
Gomm, M., Lincoln, P., Egeland, P., & Rosenberg, M. (2002). Helping hospitalised clients quit smoking: A study of rural nursing practice and barriers. Australian Journal of Rural Health, 10(1), 2632.10.1046/j.1440-1584.2002.00405.xCrossRefGoogle ScholarPubMed
Gupta, D., Winckel, K., Burrows, J., Ross, J., & Upham, J. W. (2017). Utilisation of nicotine replacement therapy within a hospital pharmacist initiated smoking-cessation intervention – A pragmatic randomised controlled trial. Journal of Smoking Cessation, 12(1), 4554. doi: 10.1017/jsc.2015.14CrossRefGoogle Scholar
McDonough, M. (2015). Update on medicines for smoking cessation. Australian Prescriber, 38(4), 106111. doi: 10.18773/austprescr.2015.038CrossRefGoogle ScholarPubMed
Metro South Health. (2019). Smoking Cessation Clinical Pathway. Retrieved from https://metrosouth.health.qld.gov.au/innovationcentral/project/smoking-cessation-clinical-pathwayGoogle Scholar
Prochaska, J. J. (2014). Engaging patients and clinicians in treating tobacco addiction. JAMA Internal Medicine, 174(8), 12991300. doi: 10.1001/jamainternmed.2014.729CrossRefGoogle ScholarPubMed
Queensland Health. (2016). Smoking Cessation Clinical Pathway. Retrieved from https://clinicalexcellence.qld.gov.au/sites/default/files/2017-11/smoking_cessation_review.pdfGoogle Scholar
Queensland Health. (2018). The health of Queenslanders 2018. Report of the Chief Health Officer Queensland. Retrieved from https://www.health.qld.gov.au/__data/assets/pdf_file/0032/732794/cho-report-2018-full.pdfGoogle Scholar
Reid, R. D., Mullen, K. A., Slovinec D'Angelo, M. E., Aitken, D. A., Papadakis, S., Haley, P. M., … Pipe, A. L. (2010). Smoking cessation for hospitalized smokers: An evaluation of the ‘Ottawa model’. Nicotine & Tobacco Research, 12(1), 1118. doi: 10.1093/ntr/ntp165CrossRefGoogle Scholar
Sharpe, T., Alsahlanee, A., Ward, K. D., & Doyle, F. (2018). Systematic review of clinician-reported barriers to provision of smoking cessation interventions in hospital inpatient settings. Journal of Smoking Cessation, 13(4), 233243.10.1017/jsc.2017.25CrossRefGoogle Scholar
Snoswell, C., & Barras, M. (2016). Inpatient smoking cessation – Turn to your clinical pharmacist. Australian and New Zealand Journal of Public Health, 40(5), 498498. doi: 10.1111/1753-6405.12567CrossRefGoogle ScholarPubMed
Stead, L. F., Bergson, G., & Lancaster, T. (2008). Physician advice for smoking cessation. Cochrane Database of Systematic Reviews, 2, 143.Google Scholar
Stefan, M. S., Pack, Q., Shieh, M.-S., Pekow, P. S., Bernstein, S. L., Raghunathan, K., … Lindenauer, P. K. (2019). The association of nicotine replacement therapy with outcomes among smokers hospitalized for a major surgical procedure. Chest, 157(5), 13541361. doi: 10.1016/j.chest.2019.10.054.CrossRefGoogle ScholarPubMed
Thomsen, T., Villebro, N., & Moller, A. M. (2010). Interventions for preoperative smoking cessation. Cochrane Database of Systematic Reviews, 7, 130.Google Scholar
Tobacco and Other Smoking Products Act 1998 (QLD). Retrieved from https://www.legislation.qld.gov.au/view/pdf/inforce/current/act-1998-001Google Scholar
US Department of Health and Human Services. (2014). The Health Consequences of Smoking – 50 years of progress A report of the Surgeon General. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK179276/pdf/Bookshelf_NBK179276.pdfGoogle Scholar
Vial, R. J., Jones, T. E., Ruffin, R. E., & Gilbert, A. L. (2002). Smoking cessation program using nicotine patches linking hospital to the community. Journal of Pharmacy Practice and Research, 32, 5762. doi: 10.1002/jppr200232157CrossRefGoogle Scholar
West, R., Raw, M., McNeill, S. L., Aveyard, P., Bitton, J., Stapleton, J., ... Borland, R. (2015). Health-care interventions to promote and assist tobacco cessation: A review of efficacy, effectiveness and affordability for use in national guideline development. Addiction, 110(9), 13881403.10.1111/add.12998CrossRefGoogle ScholarPubMed
Williams, J. H., & Jones, T. E. (2012). Smoking cessation post-discharge following nicotine replacement therapy use during an inpatient admission. Journal of Internal Medicine, 42, 154159. doi: 10.1111/j.1445-5994.2011.02442.xCrossRefGoogle ScholarPubMed
Wu, P., Wilson, K., Dimoulas, P., & Mills, E. J. (2006). Effectiveness of smoking cessation therapies: A systematic review and meta-analysis. BMC Public Health, 6, 300.10.1186/1471-2458-6-300CrossRefGoogle ScholarPubMed
Supplementary material: File

De Guzman et al. supplementary material

De Guzman et al. supplementary material

Download De Guzman et al. supplementary material(File)
File 1 MB