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Increasing the delivery of smoking
cessation in Australian hospitals
John Wiggers, Director, Hunter New England Population Health,
New South Wales, Australia
Abstract
Background:
Although evidence suggests that the provision of smoking cessation care to hospital inpatients can reduce short and long term morbidity and mortality, the routine delivery of such care by clinicians is less than optimal. Limited evidence is available that describes effective strategies for increasing such care delivery
Methods:
A quasi-experimental trial involving four hospitals in NSW Australia investigated whether a multi-strategic whole-of-hospital intervention would increase smoking care provision to all nicotine dependent inpatients. Clinical practice change strategies included local hospital committees, modification of forms and procedures, record prompts, staff training, and compliance monitoring and feedback.
Patient surveys, medical notes audits and staff surveys were used to assess delivery of: smoking status assessment, management of withdrawal symptoms; provision of nicotine replacement therapy (NRT) and post-discharge referral.
Results:
A consistent positive intervention effect was found
for the provision of NRT across all methods of data collection
(17% to 51%). Variable (across the measurement approaches) intervention effect was found for each of the other care practices.
Conclusions:
Delivery of a multi-strategic intervention is effective in increasing routine delivery by clinicians of smoking care in hospitals, particularly the provision of NRT. Further initiatives are required to enhance the provision of other elements of smoking cessation care, particularly referral on discharge.
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About the presenter
Dr John Wiggers is an Associate Professor in the School of Medicine and Public Health, University of Newcastle, Australia, and is the Director, Hunter New England Population Health, a health service unit responsible for the provision of health protection, health promotion and surveillance services to the 8000,000 residents of the Hunter New England community. John has over twenty years experience in the field of population health research and practice, and has a particular interest in the prevention of tobacco and alcohol-related harm through the modification of care and service delivery systems.
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