Smoking cessation as secondary prevention for stroke
Zofia Zielicka, Shuang Wang, Duncan Wilson, Richard Morgan and Dr Louis Koizia
Zofia Zielicka Foundation Year One Doctor, Chelsea and Westminster Hospital, London
Shuang Wang Foundation Year Two Doctor, Chelsea and Westminster Hospital, London
Dr Louis Koizia Foundation Year One Doctor, Chelsea and Westminster Hospital, London
Aim: To determine whether stroke patients admitted to Chelsea & Westminster Hospital Stroke Unit are being offered smoking cessation interventions as per NICE and Royal College of Physicians guidelines, including; verbal/written advice, pharmacotherapy and specialised clinics.
Method: Retrospective study of 51 patients from the hospital stroke database, admitted between May-August 2011, looking for smoking status documentation and any smoking cessation intervention implemented.
Results: 8 patients (16%) were current smokers, with 6 patients (75%) receiving no interventions, 1 patient (12.5%) received documented verbal advice, and 1 patient (12.5%) had all interventions. Nine patients (18%) had no documentation of smoking status.
Discussion: Active smokers who have suffered a stroke are not being offered appropriate smoking cessation strategies as part of secondary prevention. Furthermore, a smoking history is always addressed during the patientâ€™s admission. Specific strategies taken to improve this included:
- Presenting these findings and recommendations at the weekly Stroke seminars.
- Adapting the stroke admission proforma to prompt doctors to document a thorough smoking history
- Adapting the current stroke discharge summary proforma to prompt doctors to disclose current smoking status, as well as inform GPs of inpatient smoking cessation strategies that have been implemented, and advise any community input needed.
Zofia Zielicka & Shuang Wang - Foundation Year doctors with a keen interest in public health and secondary prevention programs.