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Smoking cessation and the general practice pharmacist

Published online by Cambridge University Press:  05 April 2019

Louise S Deeks ,
Sam Kosari ,
Anne Develin ,
Gregory M. Peterson  and
Mark Naunton
Louise S Deeks
Affiliation:
Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, Canberra, ACT 2601, Australia
Sam Kosari*
Affiliation:
Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, Canberra, ACT 2601, Australia
Anne Develin
Affiliation:
Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, Canberra, ACT 2601, Australia
Gregory M. Peterson
Affiliation:
Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, Canberra, ACT 2601, Australia Faculty of Health, University of Tasmania, Hobart, TAS 7001, Australia
Mark Naunton
Affiliation:
Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, Canberra, ACT 2601, Australia
*
Author for correspondence: Sam Kosari, E-mail: sam.kosari@canberra.edu.au
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Abstract

Introduction

Roles for pharmacists in general practice are developing in Australia. It is known that pharmacists can provide effective smoking cessation services in other settings but evidence in general practice is lacking.

Aim

To determine whether a pharmacist can provide effective smoking cessation services within general practice.

Method

Data from smoking cessation consultations were obtained for 66 consecutive patients seen by one practice pharmacist. The pharmacist tailored interventions to the individual. Medication was offered in collaboration with community pharmacists and general practitioners. Quit coaching, based on motivational interviewing, was conducted. Smoking status was ascertained at least 6 months after the intended quit date and verified by a carbon monoxide breath test where possible.

Results

The patients’ median age was 43 years (range 19–74 years); 42 were females (64%). At baseline, the median (i) number of pack years smoked was 20 (range: 1–75); (ii) Fagerstrom Test of dependence score was 6 (1–10); and (iii) number of previous quit attempts was 3 (0–10). Follow-up after at least 6 months determined a self-reported point prevalence abstinence rate of 30% (20/66). Of all patients who reported to be abstinent, 65% (13/20) were tested for carbon monoxide breath levels and were all below 7 ppm. The biochemically verified smoking abstinence rate was therefore 20% overall (13/66). Successful quit attempts were associated with varenicline recommendation (69% v 25%), increased median number of practice pharmacist consultations (4 v 2 per patient) and mental health diagnosis (85% v 51%).

Conclusion

Our observed abstinence rate was comparable or better than those obtained by practice nurses, community pharmacists and outpatient pharmacists, indicating the general practice pharmacist provided an effective smoking cessation intervention. A larger randomised trial is warranted.

Keywords

General practicepharmacistprimary caresmokingsmoking cessation
Type
Brief Report
Information
Journal of Smoking Cessation , Volume 14 , Issue 3 , September 2019 , pp. 186 - 189
Copyright
Copyright © The Author(s) 2019 

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References

Australian Institute of Health and Welfare. (2016). Australian burden of disease study: impact and causes of illness and death in Australia 2011. Australian Burden of Disease Study series no. 3. Cat. no. BOD 4.Google Scholar
Australian Institute of Health and Welfare. (2017). National Drug Strategy Household Survey 2016: detailed findings. Drug Statistics series no. 31. Cat. no. PHE 214.Google Scholar
Bittoun, R. (2008). Carbon monoxide meter: the essential clinical tool-the ‘stethoscope’-of smoking cessation. Journal of Smoking Cessation, 3(2), 69–70.Google Scholar
Cahill, K., Stevens, S., Perera, R. and Lancaster, T. (2013). Pharmacological interventions for smoking cessation: An overview and network meta-analysis. Cochrane Database of Systematic Reviews (5). doi: 10.1002/14651858.CD009329.pub2.Google Scholar
Costello, M. J., Sproule, B., Victor, J. C., Leatherdale, S. T., Zawertailo, L. and Selby, P. (2011) Effectiveness of pharmacist counseling combined with nicotine replacement therapy: A pragmatic randomized trial with 6,987 smokers. Cancer Causes & Control, 22(2), 167–180.Google Scholar
Deeks, L. S., Kosari, S., Boom, K., Peterson, G. M., Maina, A., Sharma, R. and Naunton, M. (2018 a). The role of pharmacists in general practice in asthma management: A pilot study. Pharmacy 6(4), E114.Google Scholar
Deeks, L. S., Kosari, S., Naunton, M., Cooper, G., Porritt, J., Davey, R., Dawda, P., Goss, J. and Kyle, G. (2018 b). Stakeholder perspectives about general practice pharmacists in the Australian Capital Territory: A qualitative pilot study. Australian Journal of Primary Health, 24(3), 263–272.Google Scholar
Deeks, L. S., Naunton, M., Tay, G. H., Peterson, G. M., Kyle, G., Davey, R., Dawda, P., Goss, J., Cooper, G. M., Porritt, J. and Kosari, S. (2018 c). What can pharmacists do in general practice? Activities of pharmacists within general practice: A pilot. Australian Journal of General Practice, 47(8), 545–549.Google Scholar
Dent, L. A., Harris, K. J. and Noonan, C. W. (2009). Randomized trial assessing the effectiveness of a pharmacist-delivered program for smoking cessation. Annals of Pharmacotherapy, 43, 194–201.Google Scholar
Dobrinas, M., Blanc, A.-L., Rouiller, F., Christen, G., Coronado, M., Tagan, D. and Schalie, C. (2014) Clinical pharmacist's role in implementing a smoking cessation intervention in a Swiss regional hospital: An exploratory study. International Journal of Clinical Pharmacy, 36, 526–534.Google Scholar
Ekpu, V. U. and Brown, A. K. (2015). The economic impact of smoking and of reducing smoking prevalence: Review of evidence. Tobacco Use Insights, 8, 1–35.Google Scholar
George, J. and Thomas, D. (2014). Tackling tobacco smoking: Opportunities for pharmacists. International Journal of Pharmacy Practice, 22(2), 103–104.Google Scholar
Heatherton, T. F., Kozlowski, L. T., Frecker, R. C. and Fagerstrom, K.-O. (1991). The Fagerström test for nicotine dependence: A revision of the Fagerstrom tolerance questionnaire. British Journal of Addiction, 86(9), 1119–1127.Google Scholar
Khachi, H. (2014). P56 impact of pharmacist-led asthma and copd reviews in general practice. Thorax, 69, A98–A99.Google Scholar
Lancaster, T. and Stead, L. F. (2017). Individual behavioural counselling for smoking cessation. Cochrane Database of Systematic Reviews (3). doi: 10.1002/14651858.CD001292.pub3.Google Scholar
Lindson-Hawley, N., Thompson, T. P. and Begh, R. (2015). Motivational interviewing for smoking cessation. Cochrane Database of Systematic Reviews (3). doi: 10.1002/14651858.CD006936.pub3.Google Scholar
MacLaren, D. J., Conigrave, K. M., Robertson, J. A., Ivers, R. G., Eades, S. and Clough, A. R. (2010). Using breath carbon monoxide to validate self-reported tobacco smoking in remote Australian Indigenous communities. Population Health Metrics, 8, 2. doi: 10.1186/1478-7954-8-2.Google Scholar
Rollnick, S., Butler, C. C. and Stott, N. (1997). Helping smokers make decisions: The enhancement of brief intervention for general medical practice. Patient Education and Counseling, 31(3), 191–203.Google Scholar
Saba, M., Diep, J., Saini, B. and Dhippayom, T. (2014). Meta-analysis of the effectiveness of smoking cessation interventions in community pharmacy. Journal of Clinical Pharmacy and Therapeutics, 39(3), 240–247.Google Scholar
Sinclair, H. K., Bond, C. M. and Stead, L. F. (2008). Community pharmacy personnel interventions for smoking cessation. Cochrane Database of Systematic Reviews (1). doi 10.1002/14651858.CD003698.pub2.Google Scholar
Siu, A. L. (2015). Behavioral and pharmacotherapy interventions for tobacco smoking cessation in adults, including pregnant women: U.S. preventive services task force recommendation statement. Annals of Internal Medicine, 163(8), 622–634.Google Scholar
Tan, E. C. K., Stewart, K., Elliott, R. A. and George, J. (2013). Stakeholder experiences with general practice pharmacist services: A qualitative study. BMJ Open, 3(9), e003214.Google Scholar
Tan, E. C. K., Stewart, K., Elliott, R. A. and George, J. (2014). Pharmacist services provided in general practice clinics: A systematic review and meta-analysis. Research in Social and Administrative Pharmacy, 10(4), 608–622.Google Scholar
The Royal Australian College of General Practitioners. (2011). Supporting smoking cessation: a guide for health professionals. Retrieved 26 February 2017 from http://www.racgp.org.au/your-practice/guidelines/smoking-cessation/Google Scholar
Zwar, N. A., Richmond, R. L., Halcomb, E. J., Furler, J. S., Smith, J. P., Hermize, O., Blackberry, I. D., Jayasinghe, U. W. and Borland, R. (2015). Quit in general practice: A cluster randomized trial of enhanced in-practice support for smoking cessation. Family Practice 32(2), 173–180.Google Scholar