Training General Practitioners in Evidence-Based Tobacco Treatment: An Evaluation of the Tobacco Treatment Training Network in Crete (TiTAN-Crete) Intervention

Girvalaki, Charis; Papadakis, Sophia; Vardavas, Constantine; Pipe, Andrew; Petridou, Eleni; Tsiligianni, Ioanna; Lionis, Christos

doi:10.1177/1090198118775481

Cited by 17 publications

(22 citation statements)

References 23 publications

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“…Despite clear guidelines, many GPs find it difficult to integrate tobacco treatment delivery into their daily clinical practice 10,11 . Previous evaluations report significant variation in the rates at which the ‘5As’ are delivered by GPs to patients, even among GPs within the same clinic 12,13 . Multi-component interventions, are interventions that combine two or more intervention strategies 14,15 .…”

Section: Introductionmentioning

confidence: 99%

“…The effectiveness of multi-component interventions is hypothesized to be related to the fact that they can address the multiple barriers to tobacco treatment delivery in the primary care setting 14 . However, variations in the rates at which providers intervene with patients who smoke continue to be documented even following exposure to multi-component interventions 12 . We hypothesize that increased knowledge of the clinic-, provider-, and patient-level factors that are associated with delivery of the ‘5As’ could aid the identification of sub-populations that might benefit from interventions to increase tobacco treatment delivery.…”

Section: Introductionmentioning

confidence: 99%

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Factors associated with rates of tobacco treatment delivery by General Practitioners in Greece: Missed opportunities for prevention?

Papadakis¹,

Girvalaki²,

Vardavas³

et al. 2018

Tob. Induc. Dis.

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INTRODUCTION This study investigates the clinic-, provider- and patient-level factors associated with delivery of 4 (Ask, Advise, Assist, Arrange) elements of the 5As approach to smoking cessation in general practice in Greece. METHODS We conducted a secondary analysis of data derived from a quasi-experimental study (The TiTAN Crete study) among general practitioners (GPs) in Crete, Greece in 2015–2016. Twenty-four GPs and a cross-sectional sample of 1301 smokers from their practices were surveyed. This paper reports on the results of the multi-level modelling conducted to examine predictors of 4As delivery. RESULTS Our analysis found clinic characteristics, including the presence of an electronic medical record, being located in a rural setting, and being in private practice were significantly associated with increased rates of tobacco treatment delivery. Female GPs were more likely than males to arrange follow-up (AOR 3.38, 95%CI 1.11, 10.35). Our analysis found a variety of patient-level factors were positively associated with tobacco treatment delivery, including: longer smoking history; presence of a smoking related illness; readiness to quit smoking; and symptoms or a diagnosis of anxiety, depression or other mental health illness. Other patient-level factors were negatively associated with tobacco treatment delivery, including level of education and reason for visit. Patients seen in clinic for episodic care were less likely to be ‘asked’ (AOR 0.22, 95%CI 0.12, 0.39), ‘advised’ (AOR 0.22, 95%CI 0.13, 0.38), and receive ‘assistance’ (AOR 0.36, 95%CI 0.19, 0.66) compared to patients seen in clinic for a medical examination. CONCLUSIONS Providers are significantly more frequently delivering tobacco treatment to a sub-group of high-risk patients compared to other tobacco users in their clinical practice. This results in missed opportunities for early intervention and disease prevention.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Factors associated with rates of tobacco treatment delivery by General Practitioners in Greece: Missed opportunities for prevention?

Papadakis¹,

Girvalaki²,

Vardavas³

et al. 2018

Tob. Induc. Dis.

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“…Previous training interventions have been found to increase the rate of 5As delivery [5][6][7] . A cluster randomised controlled trial also found that a 1-hour practice-tailored training significantly increased the frequency at which 'ask' and 'advise' were delivered 17 .…”

Section: Discussionmentioning

confidence: 98%

“…Live training interventions have been found to increase the rate of 5As delivery [5][6][7] . However, recent reviews show that there is a gap in the use of advanced computer-based medical education approaches on tobacco-treatment training for healthcare professionals 8 their daily clinical life were collected online, after consent, at the beginning of the course.…”

Section: Introductionmentioning

confidence: 99%

Current practices and perceived barriers to tobaccotreatment delivery among healthcare professionals from 15 European countries. The EPACTT Plus project

Girvalaki¹,

Mechili²,

Papadakis³

et al. 2020

Tob. Prev. Cessation

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INTRODUCTION The latest evidence-based Guidelines for Treating Tobacco Dependence highlight the significant role of healthcare professionals in supporting smokers interested to quit. This study aimed to identify the current practices of healthcare professionals in Europe and perceived barriers in delivering tobacco treatment to their patients who smoke. METHODS In the context of EPACTT-Plus, collaborating institutions from 15 countries (

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“…Its evaluation has demonstrated significant improvements in the rates at which evidence-based tobacco treatment is delivered to patients 17,18 , while TiTAN Crete is a European study that adapted the OMSC program for use in primary care settings and developed a network of trained general practitioners (GPs) in Crete, Greece, to integrate treatment of tobacco dependence into daily clinical practice. The results of TiTAN Crete demonstrated that the training intervention was effective in improving a GP's knowledge, self-efficacy and delivery of the 4As (ask, advise, assist, arrange) tobacco treatment 19 .…”

Section: Introductionmentioning

confidence: 99%

Short-term impact of the EuroPean Accredited Curriculum on Tobacco Treatment Training (EPACTT) program

Peleki¹,

Girvalaki²,

Lozano³

et al. 2018

Tob. Prev. Cessation

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INTRODUCTION The aim of this pilot study was to assess the short-term effectiveness of the EuroPean Accredited Curriculum on Tobacco Treatment Training intervention in improving health care providers' knowledge, attitudes and self-efficacy related to tobacco dependence treatment. METHODS A pre-post pilot study was conducted. The two-day training intervention took place in Brussels in April 2016. Health care professionals from six European countries (Russia, Ukraine, Georgia, Armenia, Romania and Greece) were purposively invited to participate in the study. Evaluation was performed before the intervention, immediately after, and at approximately two months following the intervention. Changes in outcomes of interest were examined before and after exposure to the intervention program. RESULTS In all, 47 health care professionals participated in the training of which 40 completed the evaluation surveys. Significant increases in providers' self-efficacy and perceived behavioral control related to tobacco treatment delivery were documented immediately following the training and at the 2 months follow-up. Significant improvement in provider knowledge and attitudes were observed in some items assessed. CONCLUSIONS The results demonstrate that training is able to improve provider self-efficacy related to tobacco treatment delivery in this crossnational European sample of health care professionals. Additional research is required to examine the generalizability of our findings.

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Training General Practitioners in Evidence-Based Tobacco Treatment: An Evaluation of the Tobacco Treatment Training Network in Crete (TiTAN-Crete) Intervention

Abstract: We found significant increases in rates at which GPs delivered evidence-based tobacco treatment following exposure to the TiTAN intervention. Future research should examine methods for supporting broader dissemination of well-designed training interventions in general practice.

Cited by 17 publications

References 23 publications

Factors associated with rates of tobacco treatment delivery by General Practitioners in Greece: Missed opportunities for prevention?

Factors associated with rates of tobacco treatment delivery by General Practitioners in Greece: Missed opportunities for prevention?

Current practices and perceived barriers to tobaccotreatment delivery among healthcare professionals from 15 European countries. The EPACTT Plus project

Short-term impact of the EuroPean Accredited Curriculum on Tobacco Treatment Training (EPACTT) program

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