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Randomized Controlled Trial
. 2010 Oct 11;170(18):1640-6.
doi: 10.1001/archinternmed.2010.344.

Engaging physicians and pharmacists in providing smoking cessation counseling

Alexander V Prokhorov  1 , Karen Suchanek Hudmon, Salma Marani, Lewis Foxhall, Kentya H Ford, Nancy Stancic Luca, David W Wetter, Scott B Cantor, Frank Vitale, Ellen R Gritz
Affiliations
Randomized Controlled Trial

Engaging physicians and pharmacists in providing smoking cessation counseling

Alexander V Prokhorov et al. Arch Intern Med. .

Abstract

Background: Health professionals have a proven, positive impact on patients' ability to quit smoking, yet few integrate cessation counseling into routine practice.The aim of this study was to evaluate the impact of continuing education training on physicians' and pharmacists' cessation counseling.

Methods: A group-randomized trial of health care providers (87 physicians and 83 pharmacists) from 16 Texas communities compared smoking cessation training (intervention group) with skin cancer prevention training (control group). Pretraining, posttraining, and extended follow-up surveys were collected from providers. Perceived ability, confidence, and intention (ACI) to address smoking with patients were assessed with a composite ACI index. Patient exit interviews (at baseline, 1452 patients completed interviews; after 12 months, 1303 completed interviews) assessed counseling practices.

Results: There was a significant increase in the percentage of physicians with a high ACI index in the intervention group from pretraining to posttraining (27% to 73%; P < .001) vs the control group (27% to 34%; P = .42) and for pharmacists (4% to 60%; P < .001) vs the control group (10% to 14%; P = .99). Similar results were seen from pretraining to extended follow-up. At baseline, fewer pharmacy patients reported being asked about smoking compared with patients seen by physicians (7% vs 33%; P = .001). There was an increase in assisting patients to quit (6% to 36%; P = .002) by physicians (baseline vs 12 months) in the intervention group, but not in the control group.

Conclusions: Training led to significant and lasting improvement in counseling among physicians. Low levels of counseling were seen among pharmacists.

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Figures

Figure 1
Figure 1
Recruitment and retention of health care providers. A, Pharmacists; B, physicians.
Figure 2
Figure 2
Health care providers’ (HCPs) perceived ability, confidence, and intention to address tobacco use (ACI index).
Figure 3
Figure 3
Numbers of patients attending exit interviews. A, Baseline survey; B, 12-month follow-up, by health care provider.
See this image and copyright information in PMC

Comment in

References

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