Implementing smoking cessation guidelines for hospitalized Veterans: Cessation results from the VA-BEST trial
| Autor: | Kathleen M. Grant, Mary Vaughan Sarrazin, David A. Katz, John E. Holman, Mark W. Vander Weg, Susan Adams, Catherine Battaglia, Steven S. Fu, Hafizur Rahman, Stephen L. Hillis, Allan V. Prochazka, David Tinkelman, Lynne Buchanan |
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| Rok vydání: | 2017 |
| Předmět: |
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medicine.medical_specialty Time Factors Hospitals Veterans medicine.medical_treatment media_common.quotation_subject Psychological intervention Medicine (miscellaneous) Smoking Prevention Logistic regression 01 natural sciences Article Academic detailing 03 medical and health sciences 0302 clinical medicine medicine Electronic Health Records Humans 030212 general & internal medicine 0101 mathematics Veterans Affairs Aged Veterans media_common Inpatients business.industry Medical record Smoking 010102 general mathematics Odds ratio Middle Aged Abstinence United States Psychiatry and Mental health Clinical Psychology Logistic Models Practice Guidelines as Topic Physical therapy Smoking cessation Female Smoking Cessation Pshychiatric Mental Health business Follow-Up Studies |
| Zdroj: | Journal of Substance Abuse Treatment. 77:79-88 |
| ISSN: | 0740-5472 |
| DOI: | 10.1016/j.jsat.2017.03.015 |
| Popis: | Purpose To examine the impact of a nurse-initiated tobacco cessation intervention focused on providing guideline-recommended care to hospitalized smokers. Design Pre-post quasi-experimental trial. Setting General medical units of four US Department of Veterans Affairs hospitals. Subjects 898 adult Veteran smokers (503 and 395 were enrolled in the baseline and intervention periods, respectively). Intervention The intervention included academic detailing, adaptation of the computerized medical record, patient self-management support, and organizational support and feedback. Measures The primary outcome was self-reported 7-day point prevalence abstinence at six months. Analysis 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. Results 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 ( CI 95 )=0.78 [0.51–1.18]) or six months ( AOR =0.92; CI 95 =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 Conclusions 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. |
| Databáze: | OpenAIRE |
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