Abstract
BackgroundUK government policy aims to strengthen the role of community pharmacies in health promotion. Thus, we conducted feasibility studies for an intervention to enhance delivery of the NHS Smoking Cessation Service.MethodsThe overall aims were to assess acceptability and feasibility of conducting the intervention in community pharmacies and piloting this with a cluster randomised trial. Specific objectives were (1) to estimate likely participation rates of pharmacies and stop smoking advisors, (2) to establish the potential impact of the training intervention on throughput and retention of smokers in smoking services, (3) to establish potential impact on smoking cessation outcomes, (4) to optimise logistics for conducting a cluster randomised trial in the next phase of the research programme and (5) to consider the feasibility of collecting pharmacy and service user data.In this cluster randomised parallel group pilot trial, 12 community pharmacies in East London were allocated to intervention or usual practice using simple randomisation (allocation ratio 2:1). Data were analysed descriptively.ResultsTwelve of 54 (22.2%, 95% CI 12.0% to 35.6%) pharmacies and 20 of 23 (87.0%, 95% CI 66.4% to 97.2%) advisors invited, agreed to participate. Over 5 months, 302 smokers in intervention pharmacies (mean per pharmacy 43.1, 95% CI: −4.3 to 90.5) and 319 in usual practice pharmacies (mean per pharmacy 79.8, 95% CI: 19.0 to 140.5) joined the service. 51 of 621 smokers (6.3% in intervention vs 10.0% in usual practice) consented to provide additional data on smoking cessation. 17 of 19 smokers that consented were retained at 4 weeks in intervention arm (89.5%, 95% CI: 66.9% to 98.7%) and 24 of 32 in usual practice (75.0%, 95% CI: 56.6% to 88.5%). 10 of 19 in the intervention arm (52.6%, 95% CI: 28.9% to 75.6%) stopped smoking compared to 7 of 32 in usual practice arm (21.9%, 95% CI: 9.3% to 40.0%).The pilot was useful in providing insights on how best to conduct the definitive trial and shortcomings of our present logistical arrangements, including feasibility of collecting pharmacy and service user data.ConclusionsRecruitment rates show that the main trial is feasible, and the results suggest that the intervention may improve retention and quit rates in smoking cessation services. We gained insights on how best to conduct the definitive trial which will proceed as planned.
Highlights
UK government policy aims to strengthen the role of community pharmacies in health promotion
Shortly after publication of the UK Department of Health white paper Smoking kills, [1] government targets were introduced to reduce the prevalence of adult smoking, and these targets were subsequently incorporated into the National Health Service (NHS) plan [2], the Cancer plan, the Priorities and Planning framework and the white paper Choosing health [3]
NHS smoking cessation services were established in 2000, and further policy initiatives led to legislation which banned smoking in public places
Summary
UK government policy aims to strengthen the role of community pharmacies in health promotion. NHS smoking cessation services were established in 2000, and further policy initiatives led to legislation which banned smoking in public places. Following these changes there was a reduction in adult smoking in England from 28% in 1998 to 22% in 2006 [4]. Further developments in government policy over this period led to strengthening primary care delivery through community pharmacies and substantial expansion of the role of pharmacists in managing a wide range of medical conditions [12, 13]. In 2014/ 15, around 48% (84961 of 450582) of all quit attempts in the NHS smoking cessation service in England were made in community pharmacies [14]
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