Effectiveness of training primary care physicians about the principles of smoking treatment

Abstract

Aim. To evaluate the impact of training primary care physicians about the principles of smoking treatment on the rate of successful quitting among their patients.Material and methods. Within the regional program on cardiovascular prevention among men aged 45-55 years, a study was made on the effectiveness of an educational seminar for primary care physicians (clustered quasi-experimental study). The main group consisted of 70 physicians (subjects of intervention) who underwent face-to-face training at a 3-hour interactive seminar on the principles of behavioral and drug treatment of smoking patients. In the following year, they consulted 423 smokers (subjects of analysis). The comparison group was represented by 174 doctors trained with extramural program who consulted 654 smokers. The doctors of both groups were provided with methodological and informational support in the form of short guides and brochures for patients. The main outcome studied was smoking cessation in patients one year after physician training. The comparison of outcomes was carried out taking into account the cluster structure of data using hierarchical regression. The initial imbalance of comparison groups in history of smoking, quit attempts, as well as level of alcohol consumption was corrected at the analysis stage.Results. In total, 12,6% of patients in the observed cohort quit smoking after one year, which was significantly higher than the common successful self-quit rate (3-5%). The likelihood of quitting smoking was strongly influenced by a particular doctor (ICC=0,326). Face-to-face interactive training of physicians significantly increased the probability of successful refusal in patients compared with distance learning (adjusted hazard ratio (HR) =4,8; odds ratio (OR) =5,3, 95% confidence interval (CI), 2,7-10,6, p<0,001). The likelihood of successful withdrawals among patients among primary care physicians was much higher than among health center patients (adjusted HR=4,5; adjusted OR, 5, 95% CI, 1,2-20,6, p=0,027).Conclusion. Education of primary care physicians in the principles of smoking treatment, combined with the provision of information materials for patients, significantly increases the success rate among motivated smokers. At the same time, a face-to-face interactive seminar is much more effective than distance learning. General practitioners demonstrate the best professional productivity, regardless of the training form.