Clinical pharmacist's role in implementing a smoking cessation intervention in a Swiss regional hospital: An exploratory study

Dobrinas, Maria; Blanc, Anne-Laure; Rouiller, François; Christen, Grégoire; Coronado, Marcos; Tagan, Damien; Schäli, C.

doi:10.1016/j.phclin.2014.04.054

Cited by 5 publications

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“…[6][7][8] Pharmacist-led interventions have been shown to be feasible and efficacious in community and ambulatory settings, but results in hospital settings have been mixed. [9][10][11][12] To the authors' knowledge, no studies to date have evaluated pharmacist-led smoking cessation programs in rehabilitation centres.…”

Section: Discussionmentioning

confidence: 99%

Implementation of a Pharmacist-Led Inpatient Tobacco Cessation Intervention in a Rehabilitation Hospital: A Before-and-After Pilot Study

Lam

Heise

et al. 2018

CJHP

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ABSTRACTBackground: Inpatient rehabilitation presents a unique opportunity for smoking interventions, given the typical lengths of stay, the relevance of smoking to the admission diagnosis of many patients, and the occurrence of nicotine withdrawal during the hospital stay.Objective: To evaluate the feasibility of implementing a pharmacist-led version of the Ottawa Model for Smoking Cessation (OMSC) program at a rehabilitation hospital, using the indicators of reach, effectiveness, adoption, and implementation.Methods: A before-and-after pilot study was conducted. Smoking cessation data were collected from 2 cohorts of eligible smokers identified during 4-month periods before (control) and after (intervention) implementation of the OMSC program. Control participants received usual care (i.e., no cessation intervention). Intervention participants received initial in-hospital smoking cessation support (counselling and nicotine replacement therapy), inpatient follow-up during the hospital stay, and 3 months of postdischarge follow-up calls, with all aspects led by hospital pharmacists.Results: Among all patients admitted to participating inpatient rehabilitation units during the 2 study periods, smoking prevalence was 7.8% (127/1626). After exclusions, deaths, and withdrawals, 111 patients were retained for analysis: 55 in the control group and 56 in the intervention group. The overall mean age of participants was 64.9 (standard deviation [SD] 14.3) years, with a mean smoking history of 35.0 (SD 24.8) pack-years. There were no significant differences between groups in terms of baseline characteristics. Self-reported abstinence rates (determined 3 months after discharge) were higher after compared with before implementation of the OMSC program: for continuous abstinence, 16/56 (28.6%) versus 9/55 (16.4%), _2 = 4.462, p = 0.035; for 7-day point prevalence abstinence, 21/56 (37.5%) versus 10/55 (18.2%), _2 = 6.807, p = 0.009.Conclusions: Implementation of the OMSC program at a large rehabilitation hospital was feasible and led to an increase in 3-month smoking abstinence. This study provides preliminary evidence to support inclusion of smoking interventions as part of inpatient rehabilitation care.RÉSUMÉContexte : La réadaptation des patients hospitalisés représente une occasion unique de procéder à des interventions de désaccoutumance du tabac, notamment en raison de la durée habituelle des séjours, du rapport entre le tabagisme et le diagnostic posé à l’admission, et de la survenue du syndrome de sevrage de la nicotine durant le séjour.Objectif : Étudier la possibilité de mettre en oeuvre une version dirigée par des pharmaciens du programme Modèle d’Ottawa pour l’abandon du tabac (MOAT) dans un centre de réadaptation en employant les indicateurs pour la portée, l’efficacité, l’adoption et la mise en oeuvre.Méthodes : Une étude pilote avant-après a été menée. Des données sur la désaccoutumance ont été recueillies auprès de deux cohortes de fumeurs admissibles qui ont été repérés pendant des périodes de quatre mois avant (groupe témoin) et après (groupe expérimental) la mise en oeuvre du programme du MOAT. Les participants du groupe témoin ont reçu les soins habituels (c.-à-d. sans intervention de désaccoutumance). Les participants du groupe expérimental ont reçu un soutien initial à l’hôpital pour la désaccoutumance du tabac (des conseils et un traitement de remplacement de la nicotine), un suivi pendant le séjour à l’hôpital, et des appels de suivi pendant les trois mois suivant le congé, le tout sous la direction de pharmaciens d’hôpitaux.Résultats : Parmi l’ensemble des patients admis dans les unités de réadaptation participantes au cours des deux périodes de l’étude, la prévalence du tabagisme était de 7,8 % (127/1626). Mis à part les exclusions, les décès et les abandons, 111 patients ont été retenus pour l’analyse : 55 dans le groupe témoin et 56 dans le groupe expérimental. L’âge moyen des participants était de 64,9 (écart-type de 14,3) ans et leur antécédent de tabagisme moyen était de 35,0 (écart-type de 24,8) paquets-années. Aucune différence significative n’a été relevée entre les groupes en ce qui touche aux caractéristiques de base. Les taux d’abstinence autodéclarée (déterminée 3 mois après le congé) étaient plus élevés après la mise en oeuvre du programme du MOAT : pour une abstinence continue, 16/56 (28,6 %) contre 9/55 (16,4 %), _2 = 4,462, p = 0,035; pour une abstinence ponctuelle de sept jours consécutifs, 21/56 (37,5 %) contre 10/55 (18,2 %), _2 = 6,807, p = 0,009.Conclusions : La mise en oeuvre du programme du MOAT dans un important centre de réadaptation a été possible et a mené à une amélioration de l’abstinence du tabac à trois mois. Cette étude donne des résultats préliminaires en appui à l’inclusion d’interventions de désaccoutumance du tabac aux soins de réadaptation de patients hospitalisés.

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Section: Discussionmentioning

confidence: 99%

Implementation of a Pharmacist-Led Inpatient Tobacco Cessation Intervention in a Rehabilitation Hospital: A Before-and-After Pilot Study

Lam

Heise

et al. 2018

CJHP

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“…In hospitals where pharmacists are accountable for obtaining medication histories, and completing medication reconciliation and medication-related education for all patients, the pharmacist offers a nearly universal access point to address tobacco use and deliver a cessation intervention. 20,21 Also, pharmacists often have the training and skills needed to recommend appropriate smoking cessation pharmacotherapies (eg, nicotine replacement therapies [NRT]) and can facilitate connections with counseling through proactive referrals to external services, such as low-barrier, toll-free tobacco quitlines. Tobacco quitlines are available in all 50 states, the District of Columbia, Guam, and Puerto Rico and have demonstrated effectiveness.…”

Section: Introductionmentioning

confidence: 99%

Development of a Pharmacist-Led Opt-Out Cessation Treatment Protocol for Combustible Tobacco Smoking Within Inpatient Settings

et al. 2021

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Background: Although people who smoke cigarettes are overrepresented among hospital inpatients, few are connected with smoking cessation treatment during their hospitalization. Training, accountability for medication use, and monitoring of all patients position pharmacists well to deliver cessation interventions to all hospitalized patients who smoke. Methods: A large Midwestern University hospital implemented a pharmacist-led smoking cessation intervention. A delegation protocol for hospital pharmacy inpatients who smoked cigarettes gave hospital pharmacists the authority to order nicotine replacement therapy (NRT) during hospitalization and upon discharge, and for referral to the Wisconsin Tobacco Quit Line (WTQL) at discharge. Eligible patients received the smoking cessation intervention unless they actively refused (ie, “opt-out”). The program was pilot tested in phases, with pharmacist feedback between phases, and then implemented hospital-wide. Interviews, surveys, and informal mechanisms identified ways to improve implementation and workflows. Results: Feedback from pharmacists led to changes that improved workflow, training and patient education materials, and enhanced adoption and reach. Refining implementation strategies across pilot phases increased the percentage of eligible smokers offered pharmacist-delivered cessation support from 37% to 76%, prescribed NRT from 2% to 44%, and referred to the WTQL from 3% to 32%. Conclusion: Hospitalizations provide an ideal opportunity for patients to make a tobacco quit attempt, and pharmacists can capitalize on this opportunity by integrating smoking cessation treatment into existing inpatient medication reconciliation workflows. Pharmacist-led implementation strategies developed in this study may be applicable in other inpatient settings.

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“…A clinical pharmacist trained for smoking cessation counselling can play a key role in providing such intercessions, including the assessment of pharmacotherapy interactions with tobacco use [103]. Prescription smoking cessation medications include bupropion and varenicline [104]. A recent Canadian survey shows that pharmacist-led intervention resulted in more than 70% of patients using nicotine replacement therapy for smoking cessation [105] (Figure 3).…”

Section: Cvd Preventionmentioning

confidence: 99%

Clinical Pharmacists in Chronic Care [Part 2]

Mohiuddin¹

2020

ABEB

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This work is licensed under Creative Commons Attribution 4.0 License ABEB.MS.ID.000566.Background Clinical pharmacology is a professional discipline that combines basic pharmacology and clinical medicine. A clinical pharmacist offers invaluable support in the development of a final prescription with better patient management and enhanced safety [1]. Its development began in the early 1950s, primarily as a result of the efforts of Harry Gold. Pharmacist rounding with inpatient hospital services has been traced to the University of Kentucky in 1957 [1,2]. Drug therapy was becoming much more complex. Graham Calder pioneered a new role for pharmacists on hospital wards in Aberdeen [3]. The role of clinical pharmacists underwent significant changes from the 1960s through 1990s as their participation in direct patient care enhanced. In the early 1970s, federal funding assisted with greatly expanding clinical pharmacy faculty in Colleges of Pharmacy [4]. Pharmacy education debated where clinical pharmacy fit within pharmacy training.The AACP spearheaded an effort to examine this issue. Till then, two full generations of pharmacists have been educated and trained after the general adoption of the aims of clinical pharmacy

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Clinical pharmacist's role in implementing a smoking cessation intervention in a Swiss regional hospital: An exploratory study

Cited by 5 publications

References 0 publications

Implementation of a Pharmacist-Led Inpatient Tobacco Cessation Intervention in a Rehabilitation Hospital: A Before-and-After Pilot Study

Implementation of a Pharmacist-Led Inpatient Tobacco Cessation Intervention in a Rehabilitation Hospital: A Before-and-After Pilot Study

Development of a Pharmacist-Led Opt-Out Cessation Treatment Protocol for Combustible Tobacco Smoking Within Inpatient Settings

Clinical Pharmacists in Chronic Care [Part 2]

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