Implementing smoking cessation guidelines for hospitalized Veterans: Cessation results from the VA-BEST trial

Weg, Mark W. Vander; Holman, John E.; Rahman, Hafizur; Vaughan-Sarrazin, Mary; Hillis, Stephen L.; Fu, Steven S.; Grant, Kathleen M.; Prochazka, Allan V.; Adams, Susan; Battaglia, Catherine; Buchanan, Lynne; Tinkelman, David G.; Katz, David A.

doi:10.1016/j.jsat.2017.03.015

Cited by 5 publications

(9 citation statements)

References 57 publications

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“… 2, 1.7% [ 69 , 101 ] 36, 30.5% [ 42 , 46 , 50 , 51 , 53 , 55 , 56 , 58 , 60 , 62 , 66 , 67 , 70 , 72 , 78 , 80 , 91 , 92 , 94 , 96 , 116 , 118 , 119 , 123 , 125 , 130 , 132 , 137 , 139 , 143 , 150 – 153 , 155 , 157 ] 38, 32.2% Present guideline materials at meetings 4, 3.4% [ 76 , 81 , 101 , 126 ] 33, 28% [ 42 , 46 , 56 , 58 , 61 , 65 , 67 , 68 , 72 , 74 , 78 , 84 , …”

Section: Resultsunclassified

“…[ 42 , 46 , 50 , 51 , 53 , 55 , 56 , 58 , 60 , 62 , 66 , 67 , 70 , 72 , 78 , 80 , 91 , 92 , 94 , 96 , 116 , 118 , 119 , 123 , 125 , 130 , 132 , 137 , 139 , 143 , 150 – 153 , 155 , 157 ]…”

Section: Resultsunclassified

“…[ 58 , 60 , 63 , 67 , 68 , 74 , 77 , 85 , 86 , 88 , 100 , 105 , 113 , 116 , 118 – 120 , 125 , 132 , 133 , 137 , 139 , 143 , 152 , 155 , 157 ]…”

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Trends in guideline implementation: an updated scoping review

et al. 2022

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Background Guidelines aim to support evidence-informed practice but are inconsistently used without implementation strategies. Our prior scoping review revealed that guideline implementation interventions were not selected and tailored based on processes known to enhance guideline uptake and impact. The purpose of this study was to update the prior scoping review. Methods We searched MEDLINE, EMBASE, AMED, CINAHL, Scopus, and the Cochrane Database of Systematic Reviews for studies published from 2014 to January 2021 that evaluated guideline implementation interventions. We screened studies in triplicate and extracted data in duplicate. We reported study and intervention characteristics and studies that achieved impact with summary statistics. Results We included 118 studies that implemented guidelines on 16 clinical topics. With regard to implementation planning, 21% of studies referred to theories or frameworks, 50% pre-identified implementation barriers, and 36% engaged stakeholders in selecting or tailoring interventions. Studies that employed frameworks (n=25) most often used the theoretical domains framework (28%) or social cognitive theory (28%). Those that pre-identified barriers (n=59) most often consulted literature (60%). Those that engaged stakeholders (n=42) most often consulted healthcare professionals (79%). Common interventions included educating professionals about guidelines (44%) and information systems/technology (41%). Most studies employed multi-faceted interventions (75%). A total of 97 (82%) studies achieved impact (improvements in one or more reported outcomes) including 10 (40% of 25) studies that employed frameworks, 28 (47.45% of 59) studies that pre-identified barriers, 22 (52.38% of 42) studies that engaged stakeholders, and 21 (70% of 30) studies that employed single interventions. Conclusions Compared to our prior review, this review found that more studies used processes to select and tailor interventions, and a wider array of types of interventions across the Mazza taxonomy. Given that most studies achieved impact, this might reinforce the need for implementation planning. However, even studies that did not plan implementation achieved impact. Similarly, even single interventions achieved impact. Thus, a future systematic review based on this data is warranted to establish if the use of frameworks, barrier identification, stakeholder engagement, and multi-faceted interventions are associated with impact. Trial registration The protocol was registered with Open Science Framework (https://osf.io/4nxpr) and published in JBI Evidence Synthesis.

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“…[ 42 , 46 , 50 , 51 , 53 , 55 , 56 , 58 , 60 , 62 , 66 , 67 , 70 , 72 , 78 , 80 , 91 , 92 , 94 , 96 , 116 , 118 , 119 , 123 , 125 , 130 , 132 , 137 , 139 , 143 , 150 – 153 , 155 , 157 ]…”

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Trends in guideline implementation: an updated scoping review

et al. 2022

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“…Generally, rural populations face multiple barriers to treatment, such as decreased access to clinics due to travel distances [12,13], reduced access to transportation [14], and lack of insurance [15,16], highlighting the need for cessation initiatives within these communities that address these barriers. For instance, although referral to tobacco treatment specialists is the prevailing model of cessation care in healthcare settings [17][18][19][20][21], this traditional approach is likely to encounter significant challenges in rural settings. This model assumes the presence of resources that are not widely available in rural communities: the availability of specialists in resource-limited settings, consistent provider referrals, and patients' ability to travel and pay for specialist visits.…”

Section: Introductionmentioning

confidence: 99%

Low Burden Strategies Are Needed to Reduce Smoking in Rural Healthcare Settings: A Lesson from Cancer Clinics

Ramsey

Baker

Pham

et al. 2020

IJERPH

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Rural populations face significant smoking-related health disparities, such as a higher prevalence of lung cancer and cancer mortality, higher prevalence of smoking, and lower likelihood of receiving cessation treatment than urban counterparts. A significant proportion of health disparities in rural populations could be eliminated with low-barrier, easy-access treatment delivery methods for smoking cessation. In this study, we assessed treatment engagement among patients in rural and urban settings. Then, we examined the effect of an electronic health record-based smoking cessation module on patient receipt of evidence-based cessation care. As part of a quality improvement project, we retrospectively observed 479,798 unique patients accounting for 1,426,089 outpatient clinical encounters from June 2018–March 2019 across 766 clinics in the greater St. Louis, southern Illinois, and mid-Missouri regions. Smoking prevalence was higher in rural versus urban clinics (20.7% vs. 13.9%, 6.7% [6.3, 7.1], odds ratio = 1.6 [1.6, 1.6], p < 0.0001), and yet rural smokers were nearly three times less likely than their urban counterparts to receive any smoking cessation treatment after adjusting for patients clustering within clinics (9.6% vs. 25.8%, −16.2% [−16.9, −15.5], odds ratio = 0.304 [0.28, 0.33], p < 0.0001). Although not yet scaled up in the rural setting, we examined the effects of a low-burden, point-of-care smoking module currently implemented in cancer clinics. After adjusting for patient clustering within clinics, patients were more likely to receive smoking treatment in clinics that implemented the module versus clinics that did not implement the module (31.2% vs. 17.5%, 13.7% [10.8, 16.6], odds ratio = 2.1 [1.8, 2.6], p < 0.0001). The point-of-care treatment approach offers a promising solution for rural settings, both in and outside the context of cancer care.

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“…En este sentido, en la recientemente publicada Normativa SEPAR (Jimenez Ruiz et al, 2017) se ha realizado una búsqueda bibliográfica de los estudios relacionados con la ayuda para dejar de fumar y, en base a los resultados, se indicaron unas recomendaciones para el tratamiento del tabaquismo en pacientes hospitalizados. Desde entonces el tema sigue vigente en publicaciones internacionales (Campos et al, 2018;Feterik et al, 2019;Vander Weg et al, 2017;Warner et al, 2016;Ylioja et al, 2017), aunque sigue faltando información relativa a la población española.…”

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Tabaquismo en pacientes hospitalizados. Una gran oportunidad

et al. 2022

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The objective of this study is to describe the characteristics of smokers admitted to different medical and surgical services in a university hospital and the perception of patients regarding the need for a specialized intervention. The sample comprises a total of 307 patients (mean age of 59.4 years), being 40% (n = 123) nonsmokers, 42.7% (n = 131) ex-smokers, and 17.3% (n = 53) smokers.The average consumption of smokers was 22.2 cigarettes / day and the severity of nicotine dependence evaluated with the Fagerström test exceeded 5 points in more than half of the sample. On the other hand, 77.7% had made at least one previous attempt to quit tobacco use. Almost the entire sample (89.9 %) of smokers and ex-smokers considered it necessary to develop tobacco treatment programs during hospitalization. Finally, the importance of the hospital context is argued as an opportunity to address the cessation of smoking. The data obtained in this study will allow focusing more appropriately on the management of these patients and optimizing resources.

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Implementing smoking cessation guidelines for hospitalized Veterans: Cessation results from the VA-BEST trial

Cited by 5 publications

References 57 publications

Trends in guideline implementation: an updated scoping review

Trends in guideline implementation: an updated scoping review

Low Burden Strategies Are Needed to Reduce Smoking in Rural Healthcare Settings: A Lesson from Cancer Clinics

Tabaquismo en pacientes hospitalizados. Una gran oportunidad

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