Effectiveness of tobacco use cessation interventions delivered by pharmacy personnel: A systematic review

Abstract

Tobacco use remains the leading cause of preventable morbidity and mortality. Implementation of tobacco use cessation interventions however requires strategies that reach large proportions of the population. Pharmacy personnel are therefore a potential human resource for delivering tobacco use cessation interventions. This review aimed to identify, describe and synthesis currently available evidence on the effectiveness of tobacco use cessation interventions delivered by pharmacy personnel. The following electronic databases were searched for studies published until May 2012: MEDLINE, EMBASE, PSYCINFO, Cochrane Library, Web of Knowledge and the Current Controlled Trials Register. This review considered controlled clinical trials and randomized controlled trials, which were comparing any pharmacy personnel delivered tobacco use cessation intervention to no treatment, usual care or other active treatments. The outcomes of interest were: abstinence (e.g., point prevalence; continuous abstinence) and relapse (e.g., time to relapse) as measured by the respective studies. The results were not pooled due to high levels of clinical heterogeneity. Ten eligible studies with a total of 20,133 participants were identified. Results suggest pharmacy personnel delivered non-pharmacological interventions offering behavioral counseling or support for tobacco use cessation could be beneficial, particularly from 6months follow-up onwards. Combining these non-pharmacological with pharmacological interventions could also be beneficial. The results for the effectiveness of nicotine replacement therapy (NRT) were mixed with some findings suggesting intervention benefits, and others suggesting no clear benefit. Pharmacy personnel-delivered non-pharmacological tobacco use cessation interventions offering behavioral counseling or support, and those combining these non-pharmacological interventions with NRT/pharmacological approaches, are potentially effective. No clear benefit has been demonstrated on pharmacy personnel-delivered NRT interventions. However, these findings are based on a very limited number of studies and hence more evidence is needed before more robust conclusions can be made.