Implementing an Inpatient Smoking Cessation Program

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Stanford Cardiac Rehabilitation Program. Contents: Foreword. Part I: Foundation. Program Administration and Management. Defining the Program Parameters. Defining the Target Population and Forecasting Enrollment. Financing and Budgeting. Part II: Program Development. Tobacco Cessation Providers. Systems for Tobacco Use Identification and Documentation. Intervention Delivery Options. Training Providers. Program Evaluation. Data and Measurement. Program Promotion. Duffy 1, 2, 3. Lee A. Ewing 2 ,. Samantha A Louzon 2 ,.


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David L Ronis 4 ,. Neil Jordan 5, 6 ,.

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Molly Harrod 2. Methods: This was a quasi-experimental, mixed methods design that collected data through electronic medical records EMR , observations of telephone smoking cessation counseling calls, interviews with staff and Veterans involved in the program, and intervention costs. Joint Commission standards for inpatient smoking with follow-up calls are voluntary, but should these standards become mandatory, there may be more motivation for VA administration to institute a hospital-based, volunteer telephone smoking cessation follow-up program. Telephone counselling for smoking cessation.

Cochrane Database Syst Rev. Interventions for smoking cessation in hospitalised patients.

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Benefits of telephone care over primary care for smoking cessation: a randomized trial. Arch Intern Med. The Joint Commission. Specifications manual for national hospital inpatient quality measures. Accessed 7 Jan J Gen Intern Med. Effectiveness of the tobacco tactics program in the Department of Veterans Affairs. Ann Behav Med. Wilson W, Pratt C.

The impact of diabetes education and peer support upon weight and glycemic control of elderly persons with noninsulin dependent diabetes mellitus NIDDM. Am J Public Health. A systematic review of the effectiveness of peer-based interventions on health-related behaviors in adults. Monitoring the dissemination of peer support in the VA Healthcare System.

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Community Ment Health J. Preliminary description of the feasibility of using peer leaders to encourage hypertension self-management. Peer mentoring and financial incentives to improve glucose control in African American veterans: a randomized trial.

Ann Intern Med. Prev Chronic Dis. Caperchione C, Coulson F.

In addition, NRT was used after discharge by Those who declined scheduled follow-up calls either felt they had already quit while in hospital and thus did not require follow-up calls or did not wish to quit. Each follow-up telephone call took 10 to 20 min. This study demonstrated the feasibility of implementing a pharmacist-led smoking cessation intervention in a rehabilitation hospital. Over the short term i.

It is also possible that pharmacists are more likely than other health care professionals to recommend NRT to patients who smoke, because of their knowledge about and comfort in using and managing the relevant medication. The proportion of patients who used NRT at home after discharge dropped to It is possible that patients had less need for NRT at home following prolonged abstinence during the hospital stay. Future research should investigate whether providing free NRT to patients after hospitalization has positive effects on the cessation rate. More commonly, follow-up offered by hospitals using the OMSC intervention begins with automated telephone calls that are monitored by nurse counsellors, who are different from the nurses with whom patients originally spoke while in hospital.

Only patients who indicate during the automated calls that they are struggling with cessation receive a call-back from a nurse counsellor. It is possible that patients prefer follow-up from a health professional whom they have met in person. The The results obtained here were positive, in contrast to the negative results obtained in a previous study of pharmacist-led smoking cessation at tertiary care hospitals. Because the majority of admissions to the rehabilitation hospital came from smoke-free acute care hospitals, the pharmacist-led interventions in this study focused on managing nicotine withdrawal symptoms and maintaining continued abstinence during hospitalization.

Differences in cessation management in rehabilitation hospitals may also have affected the study results. Expansions in scope of practice for pharmacists in Ontario have encouraged the profession to shift toward providing smoking cessation interventions as part of clinical practices. This pilot study had several limitations.

The sample was small because of the low prevalence of smoking among patients admitted to the study institution and the limited recruitment period. However, we did collect important recruitment and effectiveness data that will support planning for a larger trial. There was no biochemical verification of smoking abstinence at follow-up, so these data relied completely on self-reporting. However, as part of this pilot program, patients were informed about community resources to support smoking cessation beyond 3 months, and these may contribute to long-term smoking cessation outcomes.

In addition to determining long-term outcomes, future studies should examine the impact of hospital-based smoking cessation interventions on in-hospital smoking cessation and on health and health care outcomes, including recovery, healing, procedure complications, and length of stay. Evaluation of the sustainability of the cessation program was not assessed in the current study.

Implementation of a pharmacist-led OMSC program at the study rehabilitation hospital was feasible and led to an increase in 3-month smoking abstinence rates. This study provides preliminary evidence to support the inclusion of smoking interventions as part of inpatient rehabilitation care, both to ensure patient comfort and safety and to improve patient outcomes.

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Tobacco use in Canada: patterns and trends, edition. Specific populations: hospital-based populations. The prevalence of cigarette smoking in an acute inpatient physical medicine and rehabilitation population. Subst Abus. Interventions for smoking cessation in hospitalised patients. Cochrane Database Syst Rev. Nicotine Tob Res.

Effectiveness of a hospital-initiated smoking cessation programme: 2-year health and healthcare outcomes. Tob Control. Promoting smoking cessation during hospitalization for coronary artery disease. Can J Cardiol. Community pharmacy personnel interventions for smoking cessation.

Tobacco interventions delivered by pharmacists: a summary and systematic review. Integrating smoking cessation into routine care in hospitals—a randomized controlled trial.