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Poor initiation of smoking cessation therapies in hospitalised patients with chronic obstructive pulmonary disease is associated with low levels of formal training among hospital doctors and under-utilisation of nursing-led interventions

Citation

Pham, J and Pitney, S and Sweeney, D and Reekie, C and Harkness, N, Poor initiation of smoking cessation therapies in hospitalised patients with chronic obstructive pulmonary disease is associated with low levels of formal training among hospital doctors and under-utilisation of nursing-led interventions, Internal Medicine Journal, 50, (11) pp. 1384-1389. ISSN 1444-0903 (2020) [Refereed Article]


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DOI: doi:10.1111/imj.14645

Abstract

Background: Smoking cessation intervention is a key component in the management of chronic obstructive pulmonary disease (COPD).

Aims: To evaluate the prescribing of smoking cessation therapies (SCT) among hospital clinicians and identify factors that may hinder delivery of effective interventions.

Methods: A retrospective analysis of medical records of patients admitted to the Royal Hobart Hospital with an acute exacerbation of COPD was performed. A survey of hospital clinicians was also performed to ascertain levels of training and confidence in prescribing SCT.

Results: Nearly all medical and non-medical hospital clinicians self-reported confidence in offering SCT (91.1 vs 82.5%, respectively, P = 0.216). However, of the 122 eligible patients in our study population, the majority did not have any form of SCT initiated during their admission (n = 68, 55.7%) and only 21 patients (17.2%) were referred to the nurse-led smoking cessation service. Very few patients were initiated on efficacious regimes such as combination-nicotine replacement therapy (n = 8, 6.6%) or varenicline (n = 2, 1.6%). Only a small proportion of hospital doctors reported confidence in prescribing varenicline and bupropion (17.2 and 6.9%, respectively). Furthermore, very few hospital doctors reported ever receiving formal training in SCT compared to non-medical hospital staff (42.2 vs 84.5%, P < 0.001).

Conclusion: Our study highlights the real-life challenges in tackling nicotine dependence in hospitals: under-utilisation of evidence-based pharmacotherapies, limited access to formal training for doctors and poor uptake of nurse-led smoking cessation services. Granting limited prescribing rights for specialised nurses may help hospital clinicians to alleviate gaps in current clinical practice.

Item Details

Item Type:Refereed Article
Keywords:nicotine replacement therapy, nicotinedependence, nurse, smoking cessation, hospita
Research Division:Biomedical and Clinical Sciences
Research Group:Cardiovascular medicine and haematology
Research Field:Respiratory diseases
Objective Division:Health
Objective Group:Clinical health
Objective Field:Treatment of human diseases and conditions
UTAS Author:Pham, J (Dr Jonathan Pham)
UTAS Author:Harkness, N (Dr Nick Harkness)
ID Code:151682
Year Published:2020
Deposited By:Medicine
Deposited On:2022-08-03
Last Modified:2022-08-03
Downloads:0

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