scholarly journals Smoking Cessation Interventions in Cancer Care: Opportunities for Oncology Nurses and Nurse Scientists

2009 ◽  
Vol 27 (1) ◽  
pp. 243-272 ◽  
Author(s):  
Mary E. Cooley ◽  
Rebecca Lundin ◽  
Lyndsay Murray
Keyword(s):  
Smoking Cessation ◽  
Cancer Care ◽  
Quality Care ◽  
Tobacco Dependence ◽  
Evidence Based ◽  
Theoretical Frameworks ◽  
Behavioral Counseling ◽  
Effective Interventions ◽  
Tobacco Treatment ◽  
Attitudes Toward Smoking

Smoking cessation is essential after the diagnosis of cancer to improve clinical outcomes. The purpose of this chapter is to provide a systematic review of research on smoking cessation in the context of cancer care with an emphasis on nursing contributions to the field. Data sources included research reports of smoking cessation interventions conducted in people with cancer. Nineteen primary studies were reviewed. High intensity interventions, targeting multiple behaviors, and/or using a multicomponent intervention that included pharmacotherapy, behavioral counseling, and social support were characteristics of the most successful treatments for tobacco dependence. The majority of interventions were conducted in adults with smoking-related malignancies during acute phases of illness. The most striking finding was that more than one half of the studies tested the efficacy of nurse-delivered interventions. Conceptual and methodological issues that can be improved in future studies include: using theoretical frameworks to specify how the intervention will affect outcomes, ensuring adequate sample sizes, using biochemical verification to monitor smoking outcomes, and using standardized outcome measures of abstinence. Although effective interventions are available for healthy populations, further research is needed to determine if tailored cessation interventions are needed for patients with cancer. To provide optimal quality care it is imperative that delivery of evidence-based smoking cessation interventions be integrated into the cancer treatment trajectory. Multiple barriers, including patient and nurse attitudes toward smoking and lack of knowledge related to tobacco treatment, prevent translating evidence-based tobacco dependence treatment into clinical practice. Further nursing research is needed to address these barriers.

Preparing for an Epidemic: Cancer Care in an Aging Population

2014 ◽  
pp. 133-137 ◽  
Author(s):  
Ya-Chen Tina Shih ◽  
Arti Hurria
Keyword(s):  
Older Adults ◽  
Cancer Care ◽  
Care Delivery ◽  
Quality Care ◽  
Aging Population ◽  
Population Based ◽  
Cancer Drug ◽  
Evidence Based ◽  
Evidence Based Care

The Institute of Medicine's (IOM) Committee on Improving the Quality of Cancer Care: Addressing the Challenges of an Aging Population was charged with evaluating and proposing recommendations on how to improve the quality of cancer care, with a specific focus on the aging population. Based on their findings, the IOM committee recently released a report highlighting their 10 recommendations for improving the quality of cancer care. Based on those recommendations, this article highlights ways to improve evidence-based care and addresses rising costs in health care for older adults with cancer. The IOM highlighted three recommendations to address the current research gaps in providing evidence-based care in older adults with cancer, which included (1) studying populations which match the age and health-risk profile of the population with the disease, (2) legislative incentives for companies to include patients that are older or with multiple morbidities in new cancer drug trials, and (3) expansion of research that contributes to the depth and breadth of data available for assessing interventions. The recommendations also highlighted the need to maintain affordable and accessible care for older adults with cancer, with an emphasis on finding creative solutions within both the care delivery system and payment models in order to balance costs while preserving quality of care. The implementation of the IOM's recommendations will be a key step in moving closer to the goal of providing accessible, affordable, evidence-based, high-quality care to all patients with cancer.

Quality improvement and implementation science in cancer care: Identifying areas of synergy and opportunities for further integration.

2019 ◽  
Vol 37 (27_suppl) ◽  
pp. 29-29
Author(s):  
Devon Check ◽  
Leah L. Zullig ◽  
Melinda Davis ◽  
Angela M. Stover ◽  
Louise Davies ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Implementation Science ◽  
Cancer Care ◽  
Performance Monitoring ◽  
Care Delivery ◽  
Evidence Based ◽  
Theoretical Frameworks ◽  
Randomized Design ◽  
Stakeholder Input ◽  
The Impact

29 Background: Efforts to improve cancer care delivery have been driven by two approaches: quality improvement (QI) and implementation science (IS). QI and IS have developed independently but have potential for synergy. To inform efforts to better align these fields, we examined 20 cancer-related QI and IS articles to identify differences and areas of commonality. Methods: We searched PubMed for cancer care studies that used IS or QI methods and were published in the past 5 years in one of 17 leading journals. Through consensus-based discussions, we categorized studies as QI if they evaluated efforts to improve the quality, value, or safety of care, or IS if they evaluated efforts to promote the adoption of evidence-based interventions into practice. We identified the 10 most frequently cited studies from each category (20 total studies), characterizing and comparing their objectives, methods – including use of theoretical frameworks involvement of stakeholders – and terminology. Results: All IS studies (10/10) and half (5/10) of QI studies addressed barriers to uptake of evidence-based practices. The remaining five QI studies sought to improve clinical outcomes, reduce costs, and/or address logistical issues. QI and IS studies employed common approaches to change provider and/or organizational practice (e.g., training, performance monitoring/feedback, decision support). However, the terminology used to describe these approaches was inconsistent within and between IS and QI studies. Fewer than half (8/20) of studies (4 from each category) used a theoretical or conceptual framework and only 4/20 (2 from each category) consulted key stakeholders in developing their approach. Most studies (10/10 IS and 6/10 QI) were multi-site, and most were observational, with only 4/20 studies (2 from each category) using a randomized design to evaluate their approach. Conclusions: Cancer-related QI and IS studies had overlapping objectives and used similar approaches but used inconsistent terminology. The impact of IS and QI on cancer care delivery could be enhanced by greater harmonization of language and by promoting rigor through the use of conceptual frameworks and stakeholder input.

scholarly journals Secure Asynchronous Communication Between Smokers and Tobacco Treatment Specialists: Secondary Analysis of a Web-Assisted Tobacco Intervention in the QUIT-PRIMO and National Dental PBRN Networks

10.2196/13289 ◽  
2020 ◽  
Vol 22 (5) ◽  
pp. e13289
Author(s):  
Rajani Shankar Sadasivam ◽  
Ariana Kamberi ◽  
Kathryn DeLaughter ◽  
Barrett Phillips ◽  
Jessica H Williams ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Motivational Interviewing ◽  
Secondary Analysis ◽  
Asynchronous Communication ◽  
Evidence Based ◽  
Behavioral Strategies ◽  
Multivariable Model ◽  
Participant Engagement ◽  
Tobacco Treatment ◽  
Tobacco Intervention

Background Within a web-assisted tobacco intervention, we provided a function for smokers to asynchronously communicate with a trained tobacco treatment specialist (TTS). Previous studies have not attempted to isolate the effect of asynchronous counseling on smoking cessation. Objective This study aimed to conduct a semiquantitative analysis of TTS-smoker communication and evaluate its association with smoking cessation. Methods We conducted a secondary analysis of data on secure asynchronous communication between trained TTSs and a cohort of smokers during a 6-month period. Smokers were able to select their preferred TTS and message them using a secure web-based form. To evaluate whether the TTS used evidence-based practices, we coded messages using the Motivational Interviewing Self-Evaluation Checklist and Smoking Cessation Counseling (SCC) Scale. We assessed the content of messages initiated by the smokers by creating topical content codes. At 6 months, we assessed the association between smoking cessation and the amount of TTS use and created a multivariable model adjusting for demographic characteristics and smoking characteristics at baseline. Results Of the 725 smokers offered asynchronous counseling support, 33.8% (245/725) messaged the TTS at least once. A total of 1082 messages (TTSs: 565; smokers 517) were exchanged between the smokers and TTSs. The majority of motivational interviewing codes were those that supported client strengths (280/517, 54.1%) and promoted engagement (280/517, 54.1%). SCC code analysis showed that the TTS provided assistance to smokers if they were willing to quit (247/517, 47.8%) and helped smokers prepare to quit (206/517, 39.8%) and anticipate barriers (197/517, 38.1%). The majority of smokers’ messages discussed motivations to quit (234/565, 41.4%) and current and past treatments (talking about their previous use of nicotine replacement therapy and medications; 201/565, 35.6%). The majority of TTS messages used behavioral strategies (233/517, 45.1%), offered advice on treatments (189/517, 36.5%), and highlighted motivations to quit (171/517, 33.1%). There was no association between the amount of TTS use and cessation. In the multivariable model, after adjusting for gender, age, race, education, readiness at baseline, number of cigarettes smoked per day at baseline, and the selected TTS, smokers messaging the TTS one or two times had a smoking cessation odds ratio (OR) of 0.8 (95% CI 0.4-1.4), and those that messaged the TTS more than two times had a smoking cessation OR of 1.0 (95% CI 0.4-2.3). Conclusions Our study demonstrated the feasibility of using asynchronous counseling to deliver evidence-based counseling. Low participant engagement or a lack of power could be potential explanations for the nonassociation with smoking cessation. Future trials should explore approaches to increase participant engagement and test asynchronous counseling in combination with other approaches for improving the rates of smoking cessation.

Secure Asynchronous Communication Between Smokers and Tobacco Treatment Specialists: Secondary Analysis of a Web-Assisted Tobacco Intervention in the QUIT-PRIMO and National Dental PBRN Networks (Preprint)

2019 ◽  
Author(s):  
Rajani Shankar Sadasivam ◽  
Ariana Kamberi ◽  
Kathryn DeLaughter ◽  
Barrett Phillips ◽  
Jessica H Williams ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Motivational Interviewing ◽  
Secondary Analysis ◽  
Asynchronous Communication ◽  
Evidence Based ◽  
Behavioral Strategies ◽  
Multivariable Model ◽  
Participant Engagement ◽  
Tobacco Treatment ◽  
Tobacco Intervention

BACKGROUND Within a web-assisted tobacco intervention, we provided a function for smokers to asynchronously communicate with a trained tobacco treatment specialist (TTS). Previous studies have not attempted to isolate the effect of asynchronous counseling on smoking cessation. OBJECTIVE This study aimed to conduct a semiquantitative analysis of TTS-smoker communication and evaluate its association with smoking cessation. METHODS We conducted a secondary analysis of data on secure asynchronous communication between trained TTSs and a cohort of smokers during a 6-month period. Smokers were able to select their preferred TTS and message them using a secure web-based form. To evaluate whether the TTS used evidence-based practices, we coded messages using the Motivational Interviewing Self-Evaluation Checklist and Smoking Cessation Counseling (SCC) Scale. We assessed the content of messages initiated by the smokers by creating topical content codes. At 6 months, we assessed the association between smoking cessation and the amount of TTS use and created a multivariable model adjusting for demographic characteristics and smoking characteristics at baseline. RESULTS Of the 725 smokers offered asynchronous counseling support, 33.8% (245/725) messaged the TTS at least once. A total of 1082 messages (TTSs: 565; smokers 517) were exchanged between the smokers and TTSs. The majority of motivational interviewing codes were those that supported client strengths (280/517, 54.1%) and promoted engagement (280/517, 54.1%). SCC code analysis showed that the TTS provided assistance to smokers if they were willing to quit (247/517, 47.8%) and helped smokers prepare to quit (206/517, 39.8%) and anticipate barriers (197/517, 38.1%). The majority of smokers’ messages discussed motivations to quit (234/565, 41.4%) and current and past treatments (talking about their previous use of nicotine replacement therapy and medications; 201/565, 35.6%). The majority of TTS messages used behavioral strategies (233/517, 45.1%), offered advice on treatments (189/517, 36.5%), and highlighted motivations to quit (171/517, 33.1%). There was no association between the amount of TTS use and cessation. In the multivariable model, after adjusting for gender, age, race, education, readiness at baseline, number of cigarettes smoked per day at baseline, and the selected TTS, smokers messaging the TTS one or two times had a smoking cessation odds ratio (OR) of 0.8 (95% CI 0.4-1.4), and those that messaged the TTS more than two times had a smoking cessation OR of 1.0 (95% CI 0.4-2.3). CONCLUSIONS Our study demonstrated the feasibility of using asynchronous counseling to deliver evidence-based counseling. Low participant engagement or a lack of power could be potential explanations for the nonassociation with smoking cessation. Future trials should explore approaches to increase participant engagement and test asynchronous counseling in combination with other approaches for improving the rates of smoking cessation.

scholarly journals Global Bridges: Development and Analysis of a Tobacco Treatment Network

2016 ◽  
Vol 11 (2) ◽  
pp. 90-98 ◽  
Author(s):  
Scott J. Leischow ◽  
J. Taylor Hays ◽  
Thomas J. Glynn ◽  
Katherine E. Kemper ◽  
Janet Okamoto ◽  
...  
Keyword(s):  
Best Practices ◽  
Tobacco Control ◽  
Tobacco Dependence ◽  
Evidence Based ◽  
Tobacco Dependence Treatment ◽  
Treatment Network ◽  
Tobacco Treatment ◽  
Training Programmes ◽  
And Training

The Framework Convention on Tobacco Control (FCTC) set standards for global tobacco control, including the implementation of evidence-based tobacco dependence treatment. However, efforts to implement tobacco treatment programmes globally have been few. In order to expand tobacco treatment expertise and programmes, a new network called Global Bridges (GB) was established. This network provided training in tobacco treatment and opportunities to share best practices on implementation of tobacco dependence treatment and training programmes. In this analysis of the GB network, we found that 75% of the network members attended trainings, 60% disseminated knowledge gained through GB training, and network centralization was high (0.85). These results demonstrate initial success in network implementation, and create a foundation for expanded focus on tobacco treatment globally.

scholarly journals Outcomes of a tobacco treatment programme for individuals with severe and persistent mental illness attending a community mental health team

2013 ◽  
Vol 9 (2) ◽  
pp. 60-67 ◽  
Author(s):  
Joy E. Masuhara ◽  
Tom Heah ◽  
Chizimuzo T.C. Okoli
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Smoking Cessation ◽  
Mental Health Services ◽  
Community Mental Health ◽  
Health Services ◽  
Community Mental Health Services ◽  
Evidence Based ◽  
Persistent Mental Illness ◽  
Tobacco Treatment

Introduction: Individuals with severe and persistent mental illnesses have a greater prevalence of smoking than the general population and are disproportionately affected by tobacco-related morbidity and mortality. Evidence-based tobacco treatment can aid such populations in their efforts at smoking cessation. Few studies have examined the effectiveness of tobacco treatment programmes within Mental Health and Addictions Services in Canada.Aims: This study examines outcomes from an evidence-based tobacco treatment programme provided within community mental health services in Vancouver, Canada.Methods: A retrospective chart review was conducted of 134 participants (from June 2010 to February 2012). Information on demographics, tobacco use and cessation history, substance use history, psychiatric disorder diagnosis, expired carbon monoxide level, and duration of treatment in the programme were obtained. Programme completion and smoking cessation/reduction were examined.Results: Sixty-seven per cent completed the programme. Of those who completed, 26.7% were abstinent at the end-of-treatment and 50% (of those not achieving abstinence) reduced their consumption to at least 50% of their baseline cigarette consumption. Predictors of smoking cessation included having a social support for smoking cessation and lower nicotine dependence at baseline.Conclusions: Evidence-based tobacco treatment within community mental health services is well received by individuals with severe and persistent mental illness. Such treatment can aid in their efforts towards smoking cessation. Future studies may need to assess factors that can enhance the integration of tobacco treatment within mental health services while providing tailored treatment that addresses the unique needs of smokers who have severe and persistent mental illness.

scholarly journals Increasing the Quality and Availability of Evidence-based Treatment for Tobacco Dependence through Unified Certification of Tobacco Treatment Specialists

2014 ◽  
Vol 11 (4) ◽  
pp. 229-235 ◽  
Author(s):  
Christine E. Sheffer ◽  
Thomas Payne ◽  
Jamie S. Ostroff ◽  
Denise Jolicoeur ◽  
Michael Steinberg ◽  
...  
Keyword(s):  
Tobacco Use ◽  
Tobacco Dependence ◽  
Evidence Based ◽  
Evidence Based Treatment ◽  
High Quality Evidence ◽  
Tobacco Treatment ◽  
Quit Attempts ◽  
Evidence Based Treatments ◽  
Quality Evidence

Each year, tobacco use causes over 6 million deaths and is responsible for hundreds of billions of dollars in health care and economic costs in the world (WHO, 2011). If current trends continue, tobacco is expected to kill over 1 billion people in the 21st century, making it one of the single greatest causes of preventable death and disease in history (WHO, 2011). Long-term abstinence from tobacco use dramatically improves individuals’ health, reduces the incidence of tobacco-related disease, and is clearly responsible for saving lives (Anthonisen et al., 2005). Most tobacco users express a desire to achieve long-term abstinence from tobacco use and make numerous unsuccessful quit attempts over the course of many years (Borland, Partos, Yong, Cummings, & Hyland, 2012; CDC, 2011). Evidence-based treatments for tobacco use and dependence greatly improve the chances that quit attempts result in long-term abstinence (Chambless & Hollon, 1998; Chambless et al., 1998; Compas, Haaga, Keefe, Leitenberg, & Williams, 1998; Fiore et al., 2008; Zwar et al., 2004). Increasing the availability of high-quality evidence-based treatment for tobacco use and dependence will make it more likely that tobacco users use evidence-based treatments and that quit attempts translate into long-term abstinence. The professionalisation of treatment for tobacco dependence by the development of a rigorous, unified Tobacco Treatment Specialist (TTS) certification process will increase the availability of high-quality evidence-based treatment for tobacco use and dependence for all tobacco users.

1442Implementation and outcomes of systematic approaches to tobacco treatment: the Ottawa Model for Smoking Cessation

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Coja ◽  
K A Mullen ◽  
A L Pipe ◽  
R D Reid
Keyword(s):  
Primary Care ◽  
Smoking Cessation ◽  
Smoking Status ◽  
Evidence Based ◽  
Quit Attempt ◽  
Healthcare Settings ◽  
Tobacco Treatment ◽  
Quit Rate ◽  
Quitting Smoking

Abstract Background/Introduction Tobacco use is a major risk factor for the leading chronic diseases, is a leading cause of preventable death worldwide, and is a large cost driver of healthcare spending. Quitting smoking is the single most effective thing a patient can do to improve their health. The Ottawa Model for Smoking Cessation (OMSC) is a systematic, comprehensive approach to clinical tobacco dependence treatment. It provides support to healthcare settings in establishing a high quality tobacco treatment protocol and addressing common barriers to ensure optimal delivery of evidence-based smoking cessation interventions. Purpose The OMSC assists healthcare professionals to transform clinical practices through knowledge translation, implementation support, and quality evaluation. It promotes the delivery of evidence-based interventions to a greater number of smokers using a systematic approach, ultimately increasing cessation rates. The OMSC assists providers to identify smoking status, provide strategic advice to quit, support patients in making a quit attempt, and provide follow-up support. Methods OMSC Outreach Facilitators work with healthcare setting to assist with implementing evidence-based smoking cessation interventions. This is guided by an OMSC workplan which covers planning, implementing, evaluating and sustainability. Pre and post implementation along with program-level data is collected and used to determine rates of smoking status documentation, brief advice to stop smoking, delivery of cessation support and patient quit rates. Results The OMSC program has worked with approximately 450 healthcare settings, trained over 20,000 healthcare professionals, and supported approximately 500,000 patients with quitting smoking. Of those not ready to quit, 45% of patients seen in primary care were supported in reducing the amount they smoke. For OMSC hospital and specialty care patients receiving follow-up support, the six month responder-quit rate was 48%. For OMSC primary care patients, the two month responder-quit rate was 57%. Patients who had previously been supported by their OMSC primary care practice but had not presented to their provider in at least 6 months were contacted to assess their smoking status. Of those reached, 44% were smoke-free. Of those who relapsed, 53% indicated they would be willing to make another quit attempt, 37% of which went back to their healthcare provider to try again. Conclusion The OMSC has shown to be a simple, systematic step-by-step approach to addressing tobacco use in healthcare settings. It provides a way to create clinical efficiencies while increasing the rates at which evidence-based smoking cessation interventions are being delivered to patients, which leads to more patients making further quit attempts. The OMSC continues to expand across Canada and internationally in hopes of creating a wider smoking cessation network to support more patients with quitting smoking. Acknowledgement/Funding Ontario Ministry of Health and Long-Term Care

scholarly journals Implementation of a Comprehensive Hospital-Based Smoking-Cessation Program in Cancer

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 246s-246s
Author(s):  
N. Abdelmutti ◽  
J. Brual ◽  
J. Jones ◽  
D. Goldstein ◽  
G. Liu ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Cancer Diagnosis ◽  
Cancer Care ◽  
Performance Metrics ◽  
Smoking Status ◽  
Quality Care ◽  
Smoking Cessation Program ◽  
Successful Implementation ◽  
Patient Portal ◽  
Provider Education

Background and context: Quitting smoking after a cancer diagnosis minimizes treatment-related effects, improves prognosis and enhances quality of life. However, smoking cessation has yet to be integrated as a standard component of cancer care and cessation programs are underused. Aim: To address this gap between evidence and practice, the Princess Margaret Cancer Centre in Toronto, Canada sought to implement a comprehensive, evidence-based program that would introduce smoking cessation–related screening, referrals and education as standard practice in cancer care. Strategy/Tactics: We adapted the Framework for Managing eHealth Change to guide successful implementation of a Smoking Cessation Program (SCP) utilizing 6 components: 1) Leadership and governance 2) Stakeholder engagement and partnerships 3) Communication 4) Patient and provider education 5) Analysis and clinical integration 6) Monitoring and evaluation of program performance metrics. Program/Policy process: The SCP designed, tested and implemented a multilingual e-referral system (CEASE) to screen patients for smoking status, provide education and advice on quitting, and generate an electronic referral to cessation programs. Partnerships were established with 3 smoking-cessation programs to offer patients a breadth of services tailored to individual needs, preferences and medical history. Patient and provider education was developed to address the unique knowledge gaps, beliefs and stigma associated with smoking and a cancer diagnosis. Outcomes: Program metrics indicate that of 11,366 new patients eligible for screening between April 2017 to March 2018, 62% (n = 6629) were screened with 10% (n = 655) identifying as current smokers and 4% (n = 261) as recent quitters (6 months or less). Of smokers and recent quitters, 21% (n = 170) accepted a referral to a smoking-cessation program. What was learned: The implementation of the SCP presents a comprehensive blueprint to establish a smoking-cessation program as a standard of quality care. Elements of the SCP can be adapted to local, regional and national contexts. Future directions include assessing strategies to increase screening and referral rates, collection of long-term outcomes, and integration into the patient portal.

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