Abstract
Introduction
Tobacco smoking is the most preventable risk factor in the development of COPD. Approximately one in five patients attending general practice is a smoker. We describe a pharmacist-led smoking cessation intervention as part of an interdisciplinary model of care (RADICALS) aimed at reducing the burden of COPD and smoking in Australian primary care.
Methods
General practices (n=43) were block-randomised into ICG (interdisciplinary care group) or UCG (usual care group). Patients aged ≥40 years and self-reporting being current or ex-smokers with a smoking history of ≥10 pack years, and/or those who were managed as having COPD were invited to participate. Participants in UCG practices received routine care from their GP and Quitline referral, if appropriate. In ICG, individualised smoking cessation support was coordinated by a pharmacist on-site and offered to participants who were current smokers. Smoking cessation support was also provided by a consultant pharmacist during a home medicines review in participants with COPD. Pharmacotherapy was recommended and discussed with the participant's GP, if appropriate. Exhaled CO-verified 7-day point prevalence abstinence and changes in nicotine dependence at 6 and 12 months from baseline are outcomes.
Results
A total of 1,055 participants with a range of demographic and clinical characteristics were recruited. Of these, 693 (65.7%) were current smokers; almost all smoked daily (649, 93.7%). Median exhaled CO was 21ppm [IQR 13-28]. Smokers in ICG practices (n=373) were at various readiness-to-quit stages. Tailored pharmacist interventions ranged from motivational counselling/Quitline referral to advising on nicotine replacement therapy/varenicline use. Six month follow-ups are now complete (n=370); 12 month follow-ups will be completed by February 2018.
Conclusion
Pharmacists working with GPs can assist smokers attending general practices to quit using pharmacotherapy and non-pharmacological approaches.
Tobacco smoking is the most preventable risk factor in the development of COPD. Approximately one in five patients attending general practice is a smoker. We describe a pharmacist-led smoking cessation intervention as part of an interdisciplinary model of care (RADICALS) aimed at reducing the burden of COPD and smoking in Australian primary care.
Methods
General practices (n=43) were block-randomised into ICG (interdisciplinary care group) or UCG (usual care group). Patients aged ≥40 years and self-reporting being current or ex-smokers with a smoking history of ≥10 pack years, and/or those who were managed as having COPD were invited to participate. Participants in UCG practices received routine care from their GP and Quitline referral, if appropriate. In ICG, individualised smoking cessation support was coordinated by a pharmacist on-site and offered to participants who were current smokers. Smoking cessation support was also provided by a consultant pharmacist during a home medicines review in participants with COPD. Pharmacotherapy was recommended and discussed with the participant's GP, if appropriate. Exhaled CO-verified 7-day point prevalence abstinence and changes in nicotine dependence at 6 and 12 months from baseline are outcomes.
Results
A total of 1,055 participants with a range of demographic and clinical characteristics were recruited. Of these, 693 (65.7%) were current smokers; almost all smoked daily (649, 93.7%). Median exhaled CO was 21ppm [IQR 13-28]. Smokers in ICG practices (n=373) were at various readiness-to-quit stages. Tailored pharmacist interventions ranged from motivational counselling/Quitline referral to advising on nicotine replacement therapy/varenicline use. Six month follow-ups are now complete (n=370); 12 month follow-ups will be completed by February 2018.
Conclusion
Pharmacists working with GPs can assist smokers attending general practices to quit using pharmacotherapy and non-pharmacological approaches.
| Original language | English |
|---|---|
| Article number | TO 039 |
| Pages (from-to) | 40-40 |
| Number of pages | 1 |
| Journal | Respirology |
| Volume | 23 |
| Issue number | S1 |
| DOIs | |
| Publication status | Published - 1 Mar 2018 |
| Externally published | Yes |
Keywords
- smoking cessation
- COPD
- primary health care
- pharmacists