Abstract

You have accessJournal of UrologyCME1 May 2022MP31-08 USE OF SMOKING CESSATION PHARMACOTHERAPY FOLLOWING CYSTECTOMY AMONG SMOKERS WITH BLADDER CANCER Eli Rapoport, Marc Bjurlin, Helena Furberg, Timothy Donahue, Bernard Bochner, Jamie Ostroff, and Richard Matulewicz Eli RapoportEli Rapoport More articles by this author , Marc BjurlinMarc Bjurlin More articles by this author , Helena FurbergHelena Furberg More articles by this author , Timothy DonahueTimothy Donahue More articles by this author , Bernard BochnerBernard Bochner More articles by this author , Jamie OstroffJamie Ostroff More articles by this author , and Richard MatulewiczRichard Matulewicz More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002580.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Smoking is a leading cause of bladder cancer (BC). Despite the health benefits of smoking cessation following BC diagnosis, many patients continue smoking. Hospitalization for surgery may provide “teachable moments” to promote smoking cessation. We sought to assess whether evidence-based smoking cessation pharmacotherapies (SCP) were ordered for current smokers during hospitalizations following cystectomy. METHODS: The Premier Healthcare Database, an all-payer data set capturing 25% of US hospital admissions, was used to develop a sample of adult current smokers undergoing cystectomy for BC during 2009-2019. Primary outcome was receipt of SCP, defined as either nicotine replacement therapy (NRT) or prescription medications. Descriptive statistics were used to characterize the sample and the proportion of admissions where SCP was ordered. Associations between SCP and patient- and hospital-level factors were calculated using weighted and unweighted regressions, respectively. Associations between SCP order and surgical outcomes were explored using weighted logistic regressions. RESULTS: In total, 3676 eligible patients (weighted N=16064) were included. Median age was 64 years, 78% were male, 7.6% Black, and the median Elixhauser comorbidity score was 10. Most patients were treated at large academic centers and underwent radical cystectomy (87.5%). 27.9% of all patients received SCP; the majority (93.6%) of orders were for NRT. At the hospital level, there was significant variation in SCP delivery (Figure 1). After adjustment, older and Black patients were less likely to receive SCP. Patients having radical cystectomy and those treated at Western or Midwestern (vs. Southern) hospitals were more likely to receive SCP. Patient receipt of SCP did not have a significant association with length of stay, readmission rate, or 90-day mortality after adjusting for patient factors. Hospital-level cystectomy volume did not have a significant association with receipt of SCP (adjusted β=-0.001; 95% CI: -0.011, 0.010). CONCLUSIONS: SCP is rarely ordered for current smokers during their inpatient admission following cystectomy. This finding demonstrates a missed opportunity to initiate evidence-based smoking cessation treatment, particularly for older and Black BC patients. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e524 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Eli Rapoport More articles by this author Marc Bjurlin More articles by this author Helena Furberg More articles by this author Timothy Donahue More articles by this author Bernard Bochner More articles by this author Jamie Ostroff More articles by this author Richard Matulewicz More articles by this author Expand All Advertisement PDF DownloadLoading ...

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