Does the introduction of a systematic identification and treatment system of smokers in secondary care change usual care once the intervention is removed?
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Author(s)
Rachael L Murray, Jo Leonardi-Bee and John Britton
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| Presenter(s) |
Rachael Murray Lecturer in Health Policy & Promotion, University of Nottingham / UK Centre for Tobacco Control Studies |
Abstract BACKGROUND
Smoking status ascertainment and delivery of cessation interventions in secondary care is likely to be inconsistent. We designed a trial investigating the systematic identification and treatment of smokers in secondary care (SITS), and investigated the effect on usual care once the intervention was removed.
METHODS
Eighteen medical wards were randomised to either SITS or usual care. SITS consisted of a dedicated smoking cessation advisor providing one-to-one counselling and pharmacotherapy for the duration of admission and referral to the local stop smoking service (SSS) on discharge. Usual practice was assessed for four weeks post-delivery of SITS.
RESULTS
Delivery of behavioural support and referral to SSS is increased in usual care after SITS (from 19% to 32%, 6% to 15% and 5% to 8% respectively), although still falling far behind figures achieved by the main trial. Prescribing of NRT decreased after SITS, from 15% to 7% on admission and 20% to 10% on discharge.
CONCLUSIONS
SITS achieved a higher use of cessation support and quit rates at four-weeks post-discharge than usual care. Once SITS was removed, however, usual care standards reduced to sub-optimal levels. Future efforts need to be focused on ensuring this level of support is consistently offered within all secondary care settings.
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Presenter biography Rachael Murray is a Lecturer in Health Policy and Promotion at the University of Nottingham and is part of the UK Centre for Tobacco Control Studies. Her research interests focus on the effective delivery of smoking cessation support in secondary care and international treatment policy guidelines.
Jo Leonardi-Bee is an Associate Professor in Medical Statistics at the University of Nottingham and is part of the UK Centre for Tobacco Control Studies. Her research interests include systematic reviews of health effects of active and passive smoking.
John Britton is a Professor of Epidemiology and Head of the DIvision of Epidemiology and Public Health at the University of Nottingham, and is director of the UK Centre for Tobacco Control Studies. His research interests focus on the effective delivery of smoking cessation support in secondary care.
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Source of funding: This presentation will present independent research commissioned by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research funding scheme (RP-PG-0608-10020). The views expressed in this presentation are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health
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Declaration of interest: None
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