Feasibility and patient satisfaction with smoking cessation interventions for prevention of healthcare-associated infections in inpatients

Abstract

BackgroundSmoking increases hospitalization and healthcare-associated infection. Our primary aim of this pilot, randomized-controlled trial was to examine the feasibility and acceptability of a tobacco cessation intervention compared with usual care in inpatients. S. aureus carriage, healthcare-associated infections and infections post discharge were exploratory outcomes.MethodsCurrent inpatient smokers from a university hospital facility were randomized to usual care or a face to face tobacco cessation counseling session where patients’ tobacco use and strategies for quitting were discussed. Patient engagement, satisfaction and withdrawal symptoms were measured at 1 week and 12 weeks post discharge. Nasal swabs were collected at enrollment and discharge and assessed for S. aureus colonization. P-values were calculated using Fisher’s exact and t-tests were used to compare groups.ResultsFor the study’s primary outcome, participants reported the intervention as being generally acceptable and reported high overall levels of satisfaction, with a Likert scale score of at least 4/5 for all measures of satisfaction. No subjects utilized free tobacco cessation services after discharge. 83 % of the intervention group and 93 % of the control group smoked at least one cigarette after discharge. Secondary outcomes with regard to infections showed that, at discharge, 12 % of the intervention group (n = 17) and 18 % of the control group (n = 22) tested positive for S. aureus. After 3 months, 9 % of the intervention group developed infection, 41 % visited an emergency room, and 24 % were readmitted within 3 months post-discharge, compared to 27, 32 and 36 % of the control group respectively.ConclusionsWith regards to the primary aim of this study, there were overall high levels of satisfaction with the intervention, indicating good feasibility and acceptance among patients. However, more intensive interventions in hospitalized patients and impact on healthcare-associated infections and post-discharge infections should be explored.

Prevalence, Risk Factors and Antimicrobial Susceptibility Profile of Methicillin-Resistant <i>Staphylococcus aureus</i> (MRSA) Obtained From Nares of Patients and Staff of Sokoto State-Owned Hospitals in Nigeria

“…Regarding tobacco use, this study found that the colonization rate of S. aureus was higher among non-users of tobacco (60.5% [95% CI: 36.2-64.8]). Smokers' susceptibility to respiratory tract infections is attributed to an altered immune status and other deleterious effects of cigarette smoke components, such as damage to the airways which could eventually result in bronchitis [44]. Earlier studies have found high carriage rates of S. aureus and MRSA among non-smokers [24], [45], [46].…”

Measures of Acceptability and Feasibility of Contraceptive Counseling Interventions: A Mini-Review

“…In the studies reviewed, researchers did not highlight the importance of individual, social, and contextual factors in their intervention [16], which are very essential factors for contraceptive counseling. One critical information that came from the review is that high satisfaction from the intervention does not necessarily translate into the change in behavior [14], which is also supported by a Girl Talk intervention among adolescents [16]. Though adolescents were highly satisfied with the intervention, there was no significant reduction in subsequent pregnancies [16] mainly among those who were ≥18 years.…”

“…All studies were among adult male or female population, except the one by Gold et al 2016 which targeted female adolescents at risk of pregnancy or sexually transmitted diseases. The most common methods of measuring acceptability and feasibility across the studies were to measure participant retention rate at the end of the study [10,11], intervention compliance or number of participants attending all counseling sessions [10,12], and satisfaction with the intervention [11][12][13][14]. Participants in almost all studies reported high satisfaction with the intervention and supported the feasibility and acceptability of the intervention tools used.…”

“…Participants in almost all studies reported high satisfaction with the intervention and supported the feasibility and acceptability of the intervention tools used. In a few studies, participants suggested ways of making the intervention more effective, such as making the counseling session longer or shorter [14,15] in duration, and provide counseling closer to the date of discharge [14]. In the studies reviewed, researchers did not highlight the importance of individual, social, and contextual factors in their intervention [16], which are very essential factors for contraceptive counseling.…”

Prevalence, risk-factors, and antimicrobial susceptibility profile of methicillin-resistant Staphylococcus aureus (MRSA) obtained from nares of patients and staff of Sokoto state-owned hospitals in Nigeria

“…Regarding tobacco use, this study found that the colonization rate of S. aureus was higher among non-users of tobacco (60.5% [95% CI: 36.2–64.8]). Smokers’ susceptibility to respiratory tract infections is attributed to an altered immune status and other deleterious effects of cigarette smoke components, such as damage to the airways which could eventually result in bronchitis [ 44 ]. Earlier studies have found high carriage rates of S. aureus and MRSA among non-smokers [ 24 ], [ 45 ], [ 46 ].…”