Journal article
Implementing smoking cessation guidelines for hospitalized Veterans: Cessation results from the VA-BEST trial
Journal of substance abuse treatment, Vol.77, pp.79-88
06/2017
DOI: 10.1016/j.jsat.2017.03.015
PMCID: PMC5808890
PMID: 28476277
Abstract
To examine the impact of a nurse-initiated tobacco cessation intervention focused on providing guideline-recommended care to hospitalized smokers.
Pre-post quasi-experimental trial.
General medical units of four US Department of Veterans Affairs hospitals.
898 adult Veteran smokers (503 and 395 were enrolled in the baseline and intervention periods, respectively).
The intervention included academic detailing, adaptation of the computerized medical record, patient self-management support, and organizational support and feedback.
The primary outcome was self-reported 7-day point prevalence abstinence at six months.
Tobacco use was compared for the pre-intervention and intervention periods with multivariable logistic regression using generalized estimating equations to account for clustering at the nurse level. Predictors of abstinence at six months were investigated with best subsets regression.
Seven-day point prevalence abstinence during the intervention period did not differ significantly from the pre-intervention period at either three (adjusted odds ratio (AOR) and 95% confidence interval (CI95)=0.78 [0.51–1.18]) or six months (AOR=0.92; CI95=0.62–1.37). Predictors of abstinence included baseline self-efficacy for refraining from smoking when experiencing negative affect (p=0.0004) and perceived likelihood of staying off cigarettes following discharge (p<0.0001).
Tobacco use interventions in the VA inpatient setting likely require more substantial changes in clinician behavior and enhanced post-discharge follow-up to improve cessation outcomes.
•A nurse-initiated inpatient smoking cessation intervention did not increase quit rates, despite improvements in counseling.•Baseline self-efficacy and perceived likelihood of staying off of cigarettes predicted smoking cessation at six months.•Smoking cessation strategies effective in primary care may not translate to the inpatient setting.•More substantial changes in clinician behavior and post-discharge follow-up may be necessary to increase quit rates.
Details
- Title: Subtitle
- Implementing smoking cessation guidelines for hospitalized Veterans: Cessation results from the VA-BEST trial
- Creators
- Mark W Vander Weg - Comprehensive Access & Delivery Research and Evaluation (CADRE) Center, Iowa City VA Health Care System, United StatesJohn E Holman - Comprehensive Access & Delivery Research and Evaluation (CADRE) Center, Iowa City VA Health Care System, United StatesHafizur Rahman - Comprehensive Access & Delivery Research and Evaluation (CADRE) Center, Iowa City VA Health Care System, United StatesMary Vaughan Sarrazin - Comprehensive Access & Delivery Research and Evaluation (CADRE) Center, Iowa City VA Health Care System, United StatesStephen L Hillis - Comprehensive Access & Delivery Research and Evaluation (CADRE) Center, Iowa City VA Health Care System, United StatesSteven S Fu - Center for Chronic Disease and Outcomes Research (CCDOR), Minneapolis VA Health Care System, United StatesKathleen M Grant - Mental Health and Behavioral Sciences Department, VA Nebraska-Western Iowa Health Care System, United StatesAllan V Prochazka - Department of Medicine, VA Eastern Colorado Health Care System, United StatesSusan L Adams - Comprehensive Access & Delivery Research and Evaluation (CADRE) Center, Iowa City VA Health Care System, United StatesCatherine T Battaglia - Department of Medicine, VA Eastern Colorado Health Care System, United StatesLynne M Buchanan - The College of Nursing, University of Nebraska, United StatesDavid Tinkelman - National Jewish Health, Denver, CO, United StatesDavid A Katz - Comprehensive Access & Delivery Research and Evaluation (CADRE) Center, Iowa City VA Health Care System, United States
- Resource Type
- Journal article
- Publication Details
- Journal of substance abuse treatment, Vol.77, pp.79-88
- DOI
- 10.1016/j.jsat.2017.03.015
- PMID
- 28476277
- PMCID
- PMC5808890
- NLM abbreviation
- J Subst Abuse Treat
- ISSN
- 0740-5472
- eISSN
- 1873-6483
- Publisher
- Elsevier Inc
- Language
- English
- Date published
- 06/2017
- Academic Unit
- Radiology; Health Management and Policy; Epidemiology; Psychological and Brain Sciences; Biostatistics; Injury Prevention Research Center; General Internal Medicine; Community and Behavioral Health; Internal Medicine
- Record Identifier
- 9984051587102771
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