Abstract
IntroductionSmoking cessation has significant health benefits, and the emergency department (ED) can be an important venue for smoking cessation counseling. Nicotine replacement therapy with transdermal patches has been shown to be associated with smoking cessation in a variety of studies. This study evaluated fulfillment rates for prescriptions for nicotine replacement transdermal patches (NRT-P) from the ED.MethodsWe conducted a retrospective review of all patients receiving a prescription for a NRT-P product from January 2018–October 2019. Charts were reviewed to gather data including age, gender, presence of chronic heart or lung problems, and health insurance. We assessed the fulfillment rate of prescriptions using the Surescripts system, which is a functionality within our electronic health record system that queries participating pharmacies. Statistical analysis was conducted to determine associations between fill rates and the other variables collected from charts.ResultsWe had follow-up on 500 patients prescribed nicotine patches. Of those patients, 44% filled their prescriptions. Those who filled their prescriptions were more likely to be female and have a history of chronic lung disease. Self-pay patients were least likely to fill their prescriptions. Overall, we had evidence of smoking cessation in 13% of patients.ConclusionThis study found that a substantial proportion of patients fail to fill their NRT-P prescriptions. Further work on means of enhancing fulfillment rates is warranted.
Highlights
Smoking cessation has significant health benefits, and the emergency department (ED) can be an important venue for smoking cessation counseling
We assessed the fulfillment rate of prescriptions using the Surescripts system, which is a functionality within our electronic health record system that queries participating pharmacies
Sixty-two percent of patients were seen by an attending physician alone, while 17.6% were seen by advanced practice providers and 20.4% by resident physicians
Summary
Nicotine replacement therapy with transdermal patches has been shown to be associated with smoking cessation in a variety of studies. In a study of ED patients, about 36% of them were in the preparation stage, indicating an intention to quit within the 30 days.[2] Smoking cessation counseling can lead to sustained abstinence with the expected health benefits that come from such an effort.[3] National organizations recommend the ED as a site for intervention.[4] The importance of this topic is emphasized by a systematic review indicating that ED interventions, using a variety of methods, increases quit rates at 6-12 months from 3% in the usual care groups to 8-11% in the intervention groups.[5]
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