Smoking cessation intervention in Australian general practice: a secondary analysis of a cluster randomised controlled trial

Rukshar K. Gobarani, Nicholas A. Zwar, Grant Russell, Michael J. Abramson, Billie Bonevski, Anne E. Holland, Eldho Paul, Narelle S. Cox, Sally Wilson, Johnson George*

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

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Abstract

Background 

GPs have limited capacity to routinely provide smoking cessation support. New strategies are needed to reach all smokers within this setting. 

Aim 

To evaluate the effect of a pharmacist-coordinated interdisciplinary smoking cessation intervention delivered in Australian general practice. 

Design and setting 

Secondary analysis of a cluster randomised controlled trial (RCT) conducted in 41 Australian general practices. 

Method 

In all, 690 current smokers were included in this study: 373 from intervention clinics (n = 21) and 317 from control clinics (n = 18). A total of 166 current smokers had spirometry-confirmed chronic obstructive pulmonary disease (COPD). In the intervention clinics, trained pharmacists provided smoking cessation support plus Quitline referral. Control clinics provided usual care plus Quitline referral. Those with COPD in the intervention group (n = 84) were referred for home medicines review (HMR) and home-based pulmonary rehabilitation (HomeBase), which included further smoking cessation support. Outcomes included carbon monoxide (CO)-validated smoking abstinence, self-reported use of smoking cessation aids, and differences between groups in readiness-to-quit score at 6 months. 

Results 

Intention-to-treat analysis showed similar CO-validated abstinence rates at 6 months in the intervention (4.0%) and control clinics (3.5%). No differences were observed in readiness-to-quit scores between groups at 6 months. CO-validated abstinence rates were similar in those who completed HMR and at least six sessions of HomeBase to those with COPD in usual care.

Conclusion 

A pharmacist-coordinated interdisciplinary smoking cessation intervention when integrated in a general practice setting had no advantages over usual care. Further research is needed to evaluate the effect of HMR and home-based pulmonary rehabilitation on smoking abstinence in smokers with COPD.

Original languageEnglish
Pages (from-to)e458-e464
JournalBritish Journal of General Practice
Volume71
Issue number707
DOIs
Publication statusPublished - Jun 2021

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