Improving Smoking Cessation After Myocardial Infarction by Systematically Implementing Evidence-Based Treatment Methods: A Retrospective Observational Cohort Study

We compared the odds of smoking cessation at 2-months post-myocardial infarction (MI) before and after implementing routines, optimizing the use of evidence-based methods for smoking cessation, with start during admission. The following routines were implemented at six hospitals in Sweden: cardiac rehabilitation nurses offering smokers short consultation during admission, optimizing nicotine replacement therapy, increasing prescription of varenicline, and contacting patients by telephone during the 1st week post-discharge. Using logistic regression, odds for smoking cessation at 2-months post-MI before (n = 188) and after (n = 195) routine implementation were compared. Secondary outcomes included adherence to implemented routines. After implementation, a larger proportion of patients (65% vs 54%) were abstinent at 2-months (OR 1.60 [1.04–2.48], p = 0.034). Including only those counselled during admission, 74% were abstinent (OR 2.50 [1.42–4.41], p = 0.002). After implementation patients were more often counselled during admission (50% vs 6%, p < 0.001), prescribed varenicline (23% vs 7%, p < 0.001), and contacted by telephone post-discharge (18% vs 2%, p < 0.001). Being prescribed varenicline had the strongest association with smoking abstinence at 2-months (adjusted OR 4.09 [1.68-10.00], p = 0.002). In conclusion, readily available methods for aiding smoking cessation can be implemented effectively in routine practice, with beneficial effects on smoking cessation for the high-risk group of smoking MI patients.

Factors preventing SARS-CoV-2 transmission during unintentional exposure in a GP practice, Germany, 2020

Two general practitioners (GPs) with a SARS-CoV-2 infection provided in-person patient care to patients of their joint medical practice before and after symptom onset, up until SARS-CoV-2 laboratory confirmation. In a retrospective cohort study of patient contacts, we assessed the risk (frequency and determinants) of SARS-CoV-2 transmission from the GPs to their patients. Our findings support the use of facemasks for GPs, and short consultation time, to minimize the risk of transmission.

Foreword

<p>In the final months leading to the publication of a revised Bill in 2003, this issue of the Journal seeks to highlight the many fundamental concerns about the current draft Bill expressed by sectors working in the mental health field, by bringing together a handful of the estimated 2000 or so responses made during its short consultation period last summer. For ease of reference, the articles and commentaries which focus squarely on the implications of the draft Bill have been placed in a separate section at the end of this Journal (when editing this section, we have assumed that readers have some prior knowledge of the contents of the Bill).</p>