An audit on NRT prescription for smoking cessation in primary care
Authors: Nicole Suares, Benjamin Jones, Sophie Tuhey, Anna Winfield, Daniel Hopper, Caroline Joseph, Khatisha Seejore, Kar-hung Kuet
Presenters: Nicole Suares, Sophie Tuhey and Anna Winfield, Medical Students, University of Leeds, UK

Abstract

Background:
Smoking is a major risk factor for the development of cardiovascular disease and various cancers.  The National Institute for Health and Clinical Excellence (NICE) have issued guidelines for NRT (Nicotine Replacement Therapy) prescription, targeting this major public health issue. 

Objectives:
The aim of this audit was to investigate the adherence of healthcare professionals to NICE guidelines with regard to NRT prescription in a primary care setting.

Methodology:
The retrospective audit reviewed 200 patient records across eight general practices within Yorkshire. A questionnaire was also issued to evaluate healthcare professionals’ attitudes towards NRT prescription, allowing methodological triangulation.

Results:
None of the practices fully adhered to the guidelines, despite all questionnaire respondents claiming awareness of guidelines. Disparity existed in recording target stop dates, the treatment duration, the timing of reassessment and re-prescription despite failure.  Striking differences also occurred between practices, showing incongruity in interpreting the guidelines.  

Conclusion:
Smoking cessation therapy would benefit from better compliance with NICE guidelines. The guidelines need to be realistic and universally clarified. They would also benefit from being supported financially by a more extensive, but achievable, QOF framework.   

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About the presenter
As 4th year medical students, we have undertaken a variety of placements, including medical/surgical, paediatrics, primary care and obstetrics.

Nicole Suares: This year I have particularly enjoyed the GP and Psychiatry clinical rotations, and am keen to pursue a career in primary care. I am currently preparing a research project on Crohn’s disease for my elective.