Uptake and efficacy of a systematic intensive smoking cessation intervention using motivational interviewing for smokers hospitalised for an acute coronary syndrome: a multicentre before-after study with parallel group comparisons.

Auer, Reto; Gencer, Baris; Tango, Rodrigo; Nanchen, David; Matter, Christian M; Lüscher, Thomas Felix; Windecker, Stephan; Mach, François; Cornuz, Jacques; Humair, Jean-Paul; Rodondi, Nicolas (2016). Uptake and efficacy of a systematic intensive smoking cessation intervention using motivational interviewing for smokers hospitalised for an acute coronary syndrome: a multicentre before-after study with parallel group comparisons. BMJ open, 6(9), e011520. BMJ Publishing Group 10.1136/bmjopen-2016-011520

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OBJECTIVES To compare the efficacy of a proactive approach with a reactive approach to offer intensive smoking cessation intervention using motivational interviewing (MI). DESIGN Before-after comparison in 2 academic hospitals with parallel comparisons in 2 control hospitals. SETTING Academic hospitals in Switzerland. PARTICIPANTS Smokers hospitalised for an acute coronary syndrome (ACS). INTERVENTION In the intervention hospitals during the intervention phase, a resident physician trained in MI systematically offered counselling to all smokers admitted for ACS, followed by 4 telephone counselling sessions over 2 months by a nurse trained in MI. In the observation phase, the in-hospital intervention was offered only to patients whose clinicians requested a smoking cessation intervention. In the control hospitals, no intensive smoking cessation intervention was offered. PRIMARY AND SECONDARY OUTCOMES The primary outcome was 1 week smoking abstinence (point prevalence) at 12 months. Secondary outcomes were the number of smokers who received the in-hospital smoking cessation intervention and the duration of the intervention. RESULTS In the intervention centres during the intervention phase, 87% of smokers (N=193/225) received a smoking cessation intervention compared to 22% in the observational phase (p<0.001). Median duration of counselling was 50 min. During the intervention phase, 78% received a phone follow-up for a median total duration of 42 min in 4 sessions. Prescription of nicotine replacement therapy at discharge increased from 18% to 58% in the intervention phase (risk ratio (RR): 3.3 (95% CI 2.4 to 4.3; p≤0.001). Smoking cessation at 12-month increased from 43% to 51% comparing the observation and intervention phases (RR=1.20, 95% CI 0.98 to 1.46; p=0.08; 97% with outcome assessment). In the control hospitals, the RR for quitting was 1.02 (95% CI 0.84 to 1.25; p=0.8, 92% with outcome assessment). CONCLUSIONS A proactive strategy offering intensive smoking cessation intervention based on MI to all smokers hospitalised for ACS significantly increases the uptake of smoking cessation counselling and might increase smoking abstinence at 12 months.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine > Centre of Competence for General Internal Medicine
04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Auer, Reto; Windecker, Stephan and Rodondi, Nicolas

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

2044-6055

Publisher:

BMJ Publishing Group

Language:

English

Submitter:

Beatrice Minder Wyssmann

Date Deposited:

03 Oct 2016 11:16

Last Modified:

03 Oct 2016 11:16

Publisher DOI:

10.1136/bmjopen-2016-011520

PubMed ID:

27650761

Uncontrolled Keywords:

PREVENTIVE MEDICINE; Smoking; acute coronary syndrome; hospitalization; motivational interviewing

BORIS DOI:

10.7892/boris.89023

URI:

https://boris.unibe.ch/id/eprint/89023

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