Nurse practitioner interventions for smokers with chronic hepatitis C

Abstract

Background: Smoking is a grossly overlooked risk factor for people with chronic hepatitis C with regard to disease progression. It is unclear whether current smoking cessation interventions are effective for this population. Purpose: The purpose was to evaluate the effectiveness of a telephone counseling and nicotine replacement therapy (NRT) intervention for smokers with chronic hepatitis C to quit or reduce rates of smoking. Methods: A randomized controlled trial was conducted with participants randomized and stratified according to heaviness of smoking. Ninety-two eligible adults who smoked cigarettes and attended hepatology outpatient clinics were recruited. The intervention included NRT and telephone counseling compared with telephone counseling alone. Data collection occurred from December 2010 to November 2011. Data were collected at baseline, 6, and 12 weeks to assess smoking cessation. Change scores were analyzed using analysis of variance to examine the differences between smoking interventions. Results: At 6 weeks, both control and intervention groups had quit or reduced the number of cigarettes smoked daily. However, over 12 weeks, the intervention group showed sustained quitting or reduced smoking, with 5.8 (confidence interval [CI]: 2.4, 9.3) fewer cigarettes smoked per day from baseline. The control group maintained an average reduction of 1.6 (CI: −1.9, 5.2) fewer cigarettes per day. Implications for practice: Nicotine replacement therapy and individualized telephone counseling interventions increase the prospects of smoking cessation. Interventions such as these, introduced at routine clinic appointments in the outpatients' setting, by a nurse practitioner (hepatology) showed clinically important results for smoking cessation in this population.

Effectiveness of smoking cessation interventions for smokers with chronic diseases: A systematic review

“…All of the studies were published between 2010 and 2019. Four studies were conducted in Hong Kong (Chan et al, 2012; Li et al, 2017, 2018; Leung et al, 2019), two in the United States (Ellerbeck et al, 2018; Hennrikus et al, 2010), two in China (Lou et al, 2013; Zhou et al, 2017), one in Australia (Reid et al, 2020) and one in India (Thankappan et al, 2013). In terms of design, nine studies were RCTs (Chan et al, 2012; Li et al, 2017, 2018; Ellerbeck et al, 2018; Hennrikus et al, 2010; Leung et al, 2019; Lou et al, 2013; Reid et al, 2020; Thankappan et al, 2013), and one was a non‐RCT (Zhou et al, 2017).…”

“…Seven studies reported the years of smoking (Chan et al, 2012; Li et al, 2017, 2018; Hennrikus et al, 2010; Leung et al, 2019; Thankappan et al, 2013; Zhou et al, 2017). One study only reported the change in the Fagerström Test for Nicotine Dependence score but did not provide a baseline score (Reid et al, 2020). Taken together, these studies showed that most participants had a long history of heavy smoking and a high level of nicotine dependency.…”

“…One study involved two counselling sessions (Li et al, 2018), five studies involved three to six counselling sessions (Chan et al, 2012; Li et al, 2017; Ellerbeck et al, 2018; Thankappan et al, 2013; Zhou et al, 2017), and one study involved seven counselling sessions (Hennrikus et al, 2010). The remaining three studies did not specify the number of counselling sessions (Leung et al, 2019; Lou et al, 2013; Reid et al, 2020), although one mentioned that counselling was provided at regular intervals over a 2‐year period (Lou et al, 2013). Most of the studies did not report the duration of counselling (i.e.…”

“…Four studies adopted pharmacological interventions, such as nicotine replacement therapy (NRT), in addition to counselling (Ellerbeck et al, 2018; Leung et al, 2019; Reid et al, 2020; Zhou et al, 2017). In eight studies, the interventions were delivered by healthcare professionals, including nurses and physicians (Chan et al, 2012; Li et al, 2017; Hennrikus et al, 2010; Leung et al, 2019; Lou et al, 2013; Reid et al, 2020; Thankappan et al, 2013; Zhou et al, 2017). Trained counsellors were the interventionists in the remaining two studies (Ellerbeck et al, 2018; Li et al, 2018).…”

“…Measurements were obtained at time points ranging from 1 week to 48 months. Seven studies had final follow‐ups within 6–12 months, two studies followed participants for more than 12 months (Leung et al, 2019; Lou et al, 2013), and the remaining study conducted only a 12‐week follow‐up assessment (Reid et al, 2020). The retention rates varied across the studies and measurement time points.…”