Identifying needs of highly nicotine dependent COPD smokers using a stepped care model of psychological intervention
| Author(s)
Su Yin Yap, Myra Stern, Elizabeth Pang, Sarah Lunn and Carla Croft
| | Presenter(s) |
Dr Myra Stern Consultant Physician, Whittington Health, Whittington Hospital, London |
Dr Su Yin Yap Clinical Health Psychologist, Camden and Islington NHS Foundation Trust, London | Abstract Smoking cessation is the most effective treatment for smokers with COPD. Quit rates are low, relapse rates high. We report a pilot study assessing benefits of adjunctive psychological intervention for smokers already on intensive treatment for stop smoking.
Method: COPD smokers attending a stop smoking service were offered up to12 clinical psychology sessions. Initial assessment & formulation around factors maintaining smoking led to individualised psychological interventions. Baseline data included demographics, smoking history & disease severity. Outcomes included attendance, quit rate & thematic analysis of barriers to cessation.
Results: 57 patients (moderate COPD, high prevalence of complex physical & psychological comorbidities) were referred. 38% patients never engaged, 26% were lost to follow-up, 35% patients attended >2 sessions (mean=5, range 2-12). 7/20 had already quit (relapse prevention referrals), 13 were smokers. 86% of the relapse prevention group maintained their quit. No smoker quit although 4/13 reduced tobacco intake. Complex psychosocial barriers to quitting were identified.
Conclusions: For COPD smokers with a heavy smoking history & multiple quit attempts, additional psychological interventions with quit smoking support may aid in preventing relapse but did not increase quit rates. Findings suggest that multi-skilled teams offering more targeted psychological intervention may help this group.
| Presenter biography Dr Myra Stern (PhD, FRCP) is an Integrated Consultant Respiratory Physician. She is clinical lead for Stop Smoking at Whittington Health, London and national lead for the British Thoracic Society Stop Smoking Champions.
| Source of funding: London Borough of Islington/North Central London Public Health
| Declaration of interest: None
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