Cargando…

Increasing smoking cessation care across a network of hospitals: an implementation study

BACKGROUND: Despite clinical practice guidelines recommending the provision of smoking cessation care to all smokers in hospital, the provision of such care can be sub-optimal. A study was conducted to assess the impact of an intervention on the provision of smoking cessation care to nicotine-depend...

Descripción completa

Detalles Bibliográficos
Autores principales: Slattery, Carolyn, Freund, Megan, Gillham, Karen, Knight, Jenny, Wolfenden, Luke, Bisquera, Alessandra, Wiggers, John
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4772530/
https://www.ncbi.nlm.nih.gov/pubmed/26927023
http://dx.doi.org/10.1186/s13012-016-0390-x
_version_ 1782418587596619776
author Slattery, Carolyn
Freund, Megan
Gillham, Karen
Knight, Jenny
Wolfenden, Luke
Bisquera, Alessandra
Wiggers, John
author_facet Slattery, Carolyn
Freund, Megan
Gillham, Karen
Knight, Jenny
Wolfenden, Luke
Bisquera, Alessandra
Wiggers, John
author_sort Slattery, Carolyn
collection PubMed
description BACKGROUND: Despite clinical practice guidelines recommending the provision of smoking cessation care to all smokers in hospital, the provision of such care can be sub-optimal. A study was conducted to assess the impact of an intervention on the provision of smoking cessation care to nicotine-dependent smokers across a network of hospitals. METHODS: A 4-year interrupted time series study was undertaken in a single health district in New South Wales, Australia. A multi-component intervention was implemented over a 2-year period in all 37 public general hospitals. Outcome data were collected from eight randomly selected hospitals via medical record audit. Logistic regression analyses assessed differences between baseline, intervention and follow-up periods in the provision of seven measures of care: brief advice, offer and provision of inpatient and discharge nicotine replacement therapy, and offer and acceptance of referral to a Quitline. RESULTS: Approximately 164,250 patients were discharged from the hospitals during the study, 16 % of whom were smokers. Of the selected smokers, 56.12 % (n = 2072) were nicotine-dependent. The prevalence of smoking cessation care increased significantly for all seven measures between baseline and intervention periods, and for six of the seven measures between the baseline and follow-up periods. The odds of receiving care at follow-up were between 1.7 (CI 1.18–2.58, p = 0.0004) and 6.2 (CI 2.84–13.85, p < 0.0001) times greater than at baseline. At follow-up, 53, 16 and 7 of smokers were offered inpatient NRT, discharge NRT and a Quitline referral, respectively. CONCLUSIONS: Significant gains in the provision of smoking cessation care were indicated. However, at best, slightly more than half of the patients received smoking cessation care. Additional care enhancement strategies are required if all smokers are to obtain the intended benefits of smoking cessation care guidelines.
format Online
Article
Text
id pubmed-4772530
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-47725302016-03-02 Increasing smoking cessation care across a network of hospitals: an implementation study Slattery, Carolyn Freund, Megan Gillham, Karen Knight, Jenny Wolfenden, Luke Bisquera, Alessandra Wiggers, John Implement Sci Research BACKGROUND: Despite clinical practice guidelines recommending the provision of smoking cessation care to all smokers in hospital, the provision of such care can be sub-optimal. A study was conducted to assess the impact of an intervention on the provision of smoking cessation care to nicotine-dependent smokers across a network of hospitals. METHODS: A 4-year interrupted time series study was undertaken in a single health district in New South Wales, Australia. A multi-component intervention was implemented over a 2-year period in all 37 public general hospitals. Outcome data were collected from eight randomly selected hospitals via medical record audit. Logistic regression analyses assessed differences between baseline, intervention and follow-up periods in the provision of seven measures of care: brief advice, offer and provision of inpatient and discharge nicotine replacement therapy, and offer and acceptance of referral to a Quitline. RESULTS: Approximately 164,250 patients were discharged from the hospitals during the study, 16 % of whom were smokers. Of the selected smokers, 56.12 % (n = 2072) were nicotine-dependent. The prevalence of smoking cessation care increased significantly for all seven measures between baseline and intervention periods, and for six of the seven measures between the baseline and follow-up periods. The odds of receiving care at follow-up were between 1.7 (CI 1.18–2.58, p = 0.0004) and 6.2 (CI 2.84–13.85, p < 0.0001) times greater than at baseline. At follow-up, 53, 16 and 7 of smokers were offered inpatient NRT, discharge NRT and a Quitline referral, respectively. CONCLUSIONS: Significant gains in the provision of smoking cessation care were indicated. However, at best, slightly more than half of the patients received smoking cessation care. Additional care enhancement strategies are required if all smokers are to obtain the intended benefits of smoking cessation care guidelines. BioMed Central 2016-03-01 /pmc/articles/PMC4772530/ /pubmed/26927023 http://dx.doi.org/10.1186/s13012-016-0390-x Text en © Slattery et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Slattery, Carolyn
Freund, Megan
Gillham, Karen
Knight, Jenny
Wolfenden, Luke
Bisquera, Alessandra
Wiggers, John
Increasing smoking cessation care across a network of hospitals: an implementation study
title Increasing smoking cessation care across a network of hospitals: an implementation study
title_full Increasing smoking cessation care across a network of hospitals: an implementation study
title_fullStr Increasing smoking cessation care across a network of hospitals: an implementation study
title_full_unstemmed Increasing smoking cessation care across a network of hospitals: an implementation study
title_short Increasing smoking cessation care across a network of hospitals: an implementation study
title_sort increasing smoking cessation care across a network of hospitals: an implementation study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4772530/
https://www.ncbi.nlm.nih.gov/pubmed/26927023
http://dx.doi.org/10.1186/s13012-016-0390-x
work_keys_str_mv AT slatterycarolyn increasingsmokingcessationcareacrossanetworkofhospitalsanimplementationstudy
AT freundmegan increasingsmokingcessationcareacrossanetworkofhospitalsanimplementationstudy
AT gillhamkaren increasingsmokingcessationcareacrossanetworkofhospitalsanimplementationstudy
AT knightjenny increasingsmokingcessationcareacrossanetworkofhospitalsanimplementationstudy
AT wolfendenluke increasingsmokingcessationcareacrossanetworkofhospitalsanimplementationstudy
AT bisqueraalessandra increasingsmokingcessationcareacrossanetworkofhospitalsanimplementationstudy
AT wiggersjohn increasingsmokingcessationcareacrossanetworkofhospitalsanimplementationstudy