Abstract
BackgroundGPs have limited capacity to routinely provide smoking cessation support. New strategies are needed to reach all smokers within this setting.AimTo evaluate the effect of a pharmacist-coordinated interdisciplinary smoking cessation intervention delivered in Australian general practice.Design and settingSecondary analysis of a cluster randomised controlled trial (RCT) conducted in 41 Australian general practices.MethodIn all, 690 current smokers were included in this study: 373 from intervention clinics (n = 21) and 317 from control clinics (n = 18). A total of 166 current smokers had spirometry-confirmed chronic obstructive pulmonary disease (COPD). In the intervention clinics, trained pharmacists provided smoking cessation support plus Quitline referral. Control clinics provided usual care plus Quitline referral. Those with COPD in the intervention group (n = 84) were referred for home medicines review (HMR) and home-based pulmonary rehabilitation (HomeBase), which included further smoking cessation support. Outcomes included carbon monoxide (CO)-validated smoking abstinence, self-reported use of smoking cessation aids, and differences between groups in readiness-to-quit score at 6 months.ResultsIntention-to-treat analysis showed similar CO-validated abstinence rates at 6 months in the intervention (4.0%) and control clinics (3.5%). No differences were observed in readiness-to-quit scores between groups at 6 months. CO-validated abstinence rates were similar in those who completed HMR and at least six sessions of HomeBase to those with COPD in usual care.ConclusionA pharmacist-coordinated interdisciplinary smoking cessation intervention when integrated in a general practice setting had no advantages over usual care. Further research is needed to evaluate the effect of HMR and home-based pulmonary rehabilitation on smoking abstinence in smokers with COPD.
Highlights
Smoking is the primary risk factor for the development of many chronic conditions, including chronic obstructive pulmonary disease (COPD)
A pharmacist-coordinated interdisciplinary smoking cessation intervention when integrated in a general practice setting had no advantages over usual care
Further research is needed to evaluate the effect of home medicines review (HMR) and homebased pulmonary rehabilitation on smoking abstinence in smokers with COPD
Summary
Smoking is the primary risk factor for the development of many chronic conditions, including chronic obstructive pulmonary disease (COPD). Despite the progressive nature of COPD and the negative impacts on an individual’s quality of life, approximately 40% of people with COPD continue to smoke, and often find it more difficult to quit than other smokers.[1,2]. Given their high degree of contact with the population, GPs are well placed to assist in smoking cessation.[3] Despite this, a study conducted across 30 urban and rural general practice clinics in Australia reported that GPs provided smoking-related advice to only 55% of smokers who were ready to change their smoking behaviours.[4]. New strategies are needed to reach all smokers within this setting
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