Integrating smoking cessation into routine care in hospitals-a randomized controlled trial

D. Thomas, M. J. Abramson, B. Bonevski, S. Taylor, S. G. Poole, E. Paul, G. R. Weeks, M. J. Dooley, J. George

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Abstract

Aims: To evaluate the effectiveness of a pharmacist-led multi-component smoking cessation programme (GIVE UP FOR GOOD) compared with usual care in hospitalized smokers. 

Design: Randomized, assessor-blinded, parallel-group trial. Setting: Three tertiary public hospitals in Australia. Participants: A total of 600 adult in-patient smokers [mean ± standard deviation (SD), age 51 ± 14 years; 64% male] available for 12 months follow-up. 

Interventions: Multi-component hospital pharmacist-led behavioural counselling and/or pharmacotherapy provided during hospital stay, on discharge and 1 month post-discharge, with further support involving community health professionals (n = 300). Usual care comprised routine care provided by hospitals (n = 300). 

Measurements: Two primary end-points were tested using intention-to-treat analysis: carbon monoxide (CO)-validated 1-month sustained abstinence at 6-month follow-up and verified 6-month sustained abstinence at 12-month follow-up. Smoking status and pharmacotherapy usage were assessed at baseline, discharge, 1, 6 and 12 months. Findings: Sustained abstinence rates for intervention and control groups were not significantly different at both 6 months [11.6% (34 of 294) versus 12.6% (37 of 294); odds ratio (OR) = 0.91, 95% confidence interval (CI) = 0.55-1.50] and 12 months [11.6% (34 of 292) versus 11.2% (33 of 294); OR = 1.04, 95% CI = 0.63-1.73]. Secondary end-points, self-reported continuous abstinence at 6 and 12 months, also agreed with the primary end-points. Use of pharmacotherapy was higher in the intervention group, both during hospital stay [52.3% (157 of 300) versus 42.7% (128 of 300); P = 0.016] and after discharge [59.6% (174 of 292) versus 43.5% (128 of 294); P <0.001]. 

Conclusions: A pharmacist-led multi-component smoking cessation intervention provided during hospital stay did not improve sustained abstinence rates at either 6 or 12 months compared with routine hospital care.

Original languageEnglish
Pages (from-to)714-723
Number of pages10
JournalAddiction
Volume111
Issue number4
DOIs
Publication statusPublished - 1 Apr 2016

Keywords

  • Hospitals
  • Pharmacists
  • Randomized controlled trial
  • Smoking cessation

Cite this

Thomas, D. ; Abramson, M. J. ; Bonevski, B. ; Taylor, S. ; Poole, S. G. ; Paul, E. ; Weeks, G. R. ; Dooley, M. J. ; George, J. / Integrating smoking cessation into routine care in hospitals-a randomized controlled trial. In: Addiction. 2016 ; Vol. 111, No. 4. pp. 714-723.
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title = "Integrating smoking cessation into routine care in hospitals-a randomized controlled trial",
abstract = "Aims: To evaluate the effectiveness of a pharmacist-led multi-component smoking cessation programme (GIVE UP FOR GOOD) compared with usual care in hospitalized smokers. Design: Randomized, assessor-blinded, parallel-group trial. Setting: Three tertiary public hospitals in Australia. Participants: A total of 600 adult in-patient smokers [mean ± standard deviation (SD), age 51 ± 14 years; 64{\%} male] available for 12 months follow-up. Interventions: Multi-component hospital pharmacist-led behavioural counselling and/or pharmacotherapy provided during hospital stay, on discharge and 1 month post-discharge, with further support involving community health professionals (n = 300). Usual care comprised routine care provided by hospitals (n = 300). Measurements: Two primary end-points were tested using intention-to-treat analysis: carbon monoxide (CO)-validated 1-month sustained abstinence at 6-month follow-up and verified 6-month sustained abstinence at 12-month follow-up. Smoking status and pharmacotherapy usage were assessed at baseline, discharge, 1, 6 and 12 months. Findings: Sustained abstinence rates for intervention and control groups were not significantly different at both 6 months [11.6{\%} (34 of 294) versus 12.6{\%} (37 of 294); odds ratio (OR) = 0.91, 95{\%} confidence interval (CI) = 0.55-1.50] and 12 months [11.6{\%} (34 of 292) versus 11.2{\%} (33 of 294); OR = 1.04, 95{\%} CI = 0.63-1.73]. Secondary end-points, self-reported continuous abstinence at 6 and 12 months, also agreed with the primary end-points. Use of pharmacotherapy was higher in the intervention group, both during hospital stay [52.3{\%} (157 of 300) versus 42.7{\%} (128 of 300); P = 0.016] and after discharge [59.6{\%} (174 of 292) versus 43.5{\%} (128 of 294); P <0.001]. Conclusions: A pharmacist-led multi-component smoking cessation intervention provided during hospital stay did not improve sustained abstinence rates at either 6 or 12 months compared with routine hospital care.",
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Integrating smoking cessation into routine care in hospitals-a randomized controlled trial. / Thomas, D.; Abramson, M. J.; Bonevski, B.; Taylor, S.; Poole, S. G.; Paul, E.; Weeks, G. R.; Dooley, M. J.; George, J.

In: Addiction, Vol. 111, No. 4, 01.04.2016, p. 714-723.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Integrating smoking cessation into routine care in hospitals-a randomized controlled trial

AU - Thomas, D.

AU - Abramson, M. J.

AU - Bonevski, B.

AU - Taylor, S.

AU - Poole, S. G.

AU - Paul, E.

AU - Weeks, G. R.

AU - Dooley, M. J.

AU - George, J.

PY - 2016/4/1

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N2 - Aims: To evaluate the effectiveness of a pharmacist-led multi-component smoking cessation programme (GIVE UP FOR GOOD) compared with usual care in hospitalized smokers. Design: Randomized, assessor-blinded, parallel-group trial. Setting: Three tertiary public hospitals in Australia. Participants: A total of 600 adult in-patient smokers [mean ± standard deviation (SD), age 51 ± 14 years; 64% male] available for 12 months follow-up. Interventions: Multi-component hospital pharmacist-led behavioural counselling and/or pharmacotherapy provided during hospital stay, on discharge and 1 month post-discharge, with further support involving community health professionals (n = 300). Usual care comprised routine care provided by hospitals (n = 300). Measurements: Two primary end-points were tested using intention-to-treat analysis: carbon monoxide (CO)-validated 1-month sustained abstinence at 6-month follow-up and verified 6-month sustained abstinence at 12-month follow-up. Smoking status and pharmacotherapy usage were assessed at baseline, discharge, 1, 6 and 12 months. Findings: Sustained abstinence rates for intervention and control groups were not significantly different at both 6 months [11.6% (34 of 294) versus 12.6% (37 of 294); odds ratio (OR) = 0.91, 95% confidence interval (CI) = 0.55-1.50] and 12 months [11.6% (34 of 292) versus 11.2% (33 of 294); OR = 1.04, 95% CI = 0.63-1.73]. Secondary end-points, self-reported continuous abstinence at 6 and 12 months, also agreed with the primary end-points. Use of pharmacotherapy was higher in the intervention group, both during hospital stay [52.3% (157 of 300) versus 42.7% (128 of 300); P = 0.016] and after discharge [59.6% (174 of 292) versus 43.5% (128 of 294); P <0.001]. Conclusions: A pharmacist-led multi-component smoking cessation intervention provided during hospital stay did not improve sustained abstinence rates at either 6 or 12 months compared with routine hospital care.

AB - Aims: To evaluate the effectiveness of a pharmacist-led multi-component smoking cessation programme (GIVE UP FOR GOOD) compared with usual care in hospitalized smokers. Design: Randomized, assessor-blinded, parallel-group trial. Setting: Three tertiary public hospitals in Australia. Participants: A total of 600 adult in-patient smokers [mean ± standard deviation (SD), age 51 ± 14 years; 64% male] available for 12 months follow-up. Interventions: Multi-component hospital pharmacist-led behavioural counselling and/or pharmacotherapy provided during hospital stay, on discharge and 1 month post-discharge, with further support involving community health professionals (n = 300). Usual care comprised routine care provided by hospitals (n = 300). Measurements: Two primary end-points were tested using intention-to-treat analysis: carbon monoxide (CO)-validated 1-month sustained abstinence at 6-month follow-up and verified 6-month sustained abstinence at 12-month follow-up. Smoking status and pharmacotherapy usage were assessed at baseline, discharge, 1, 6 and 12 months. Findings: Sustained abstinence rates for intervention and control groups were not significantly different at both 6 months [11.6% (34 of 294) versus 12.6% (37 of 294); odds ratio (OR) = 0.91, 95% confidence interval (CI) = 0.55-1.50] and 12 months [11.6% (34 of 292) versus 11.2% (33 of 294); OR = 1.04, 95% CI = 0.63-1.73]. Secondary end-points, self-reported continuous abstinence at 6 and 12 months, also agreed with the primary end-points. Use of pharmacotherapy was higher in the intervention group, both during hospital stay [52.3% (157 of 300) versus 42.7% (128 of 300); P = 0.016] and after discharge [59.6% (174 of 292) versus 43.5% (128 of 294); P <0.001]. Conclusions: A pharmacist-led multi-component smoking cessation intervention provided during hospital stay did not improve sustained abstinence rates at either 6 or 12 months compared with routine hospital care.

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KW - Pharmacists

KW - Randomized controlled trial

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