Smoking cessation outcome in NCD clinic of Thailand community hospital: Pharmacist-led
Article Sidebar
Main Article Content
Abstract
Background: Smoking is the major risk for cardiovascular events in non-communicable chronic diseases; hypertension and diabetes. Smoking cessation is high effective intervention to reduce its morbidity and mortality. However clearly assessment for outcome in Thailand especially by pharmacist-led is scarce. Objectives: This study aim to assess the smoking cessation outcome, stage of change and cardiovascular disease (CVD) risk reduction at 1 year follow-up by pharmacist-led. Method: A quasi experiment prospective study recruited the current smoker with hypertension and diabetes at out-patient department Paknum-Chumphon hospital during January 2014 – January 2015. Baseline and follow-up measurement after 1, 2 weeks, 1, 2, 6 months and 1 year endpoint were performed. The primary outcomes were the interim quit rate, the reduction of number of cigarettes per day, fagerstrom score, stage of change and abstinence rate at 1 year of follow-up. Secondary outcomes were Framingham 10-year CVD risk lowering. The statistical significant level (α) = 0.05. Results: The total of 176 patients, the majority were male and the average age were 55.5 years (SD=13.7). The number of patients with hypertension, diabetes and both were 59.7%, 33.5% and 6.8% respectively. The reduction of number of cigarettes per day and nicotine dependence level (fagerstrom score) in the follow-up duration were significant (One-way ANOVA p=0.001*, p=0.001*). The number of cigarette per day were decrease from 12.4 (SD=7.9) to 2.7 (SD=3.5) and stage of change were significantly changed to maintenance (X2-test p=0.001*). Total abstinence rate at 1 year was 30.7%. Abstinence rate in patients with hypertension, diabetes and both were 30.1%, 32.2% and 33.3% respectively. The CVD risk reduction according to Framingham 10-year general cardiovascular risk score; at 1 year follow-up the patients with high risk level (20% - <30%) – very high risk level (30% - <40%) were reduced from 32.6% to 24.4%. The Framingham 10-year CVD risk score were significantly reduced both in patient with hypertension and diabetes and the average lowering were 15.26% (SD=7.79) to 13.54% (SD=7.32) (paired t-test p=0.001*). Conclusion: The pharmacist-led smoking cessation in non-communicable chronic diseases were effective in smoking cessation and harm reduction. That provided the benefit in CVD risk reduction.
Article Details
In the case that some parts are used by others The author must Confirm that obtaining permission to use some of the original authors. And must attach evidence That the permission has been included
References
Athyros VG, Katsiki N, Doumas M, Karagiannis A and Mikhailidis DP. Effect of tobacco smoking and smoking cessation on plasma lipoproteins and associated major cardiovascular risk factors: a narrative review. Curr Med Res Opin 2013, 29(10): 1263-74.
Aung MN, Yuasa M, Lorga T, Moolphate S, Hiroshi Fukuda H, Kitajima T, et al. Evidencebased new service package vs. routine service package for smoking cessation to prevent high risk patients from cardiovascular diseases (CVD): study protocol for randomized controlled trial. Trials 2013, 14:419.
Berndt N, Bolman C, Lechner L, Mudde A, Verheugt FW and Vries H. Effectiveness of two intensive treatment methods for smoking cessation and relapse prevention in patients with coronary heart disease:
study protocol and baseline description. BMC Cardiovascular Disorders 2012, 12:33.
Bush T, Zbikowski S, Mahoney L, Deprey M, Mowery PD and Magnusson B. The 2009 US Federal Cigarette Tax Increase and Quitline Utilization in 16 States. J Enviro Public Health 2012, Article ID 314740, 1-9.
Bussaratid S and Siripaiboomkit A. Study of smoking cessation rate at smoking cessation clinic, Siriraj hospital. J Psychiat Assoc Thailand 2012, 57(3): 305-12.
Chronic Disease Prevention and Health Promotion. Tobacco Use Targeting the Nation’s Leading Killer At A Glance 2011. Available at http://www.cdc.gov/chronicdisease/resources/publications/aag/osh.htm. Accessed Feb 15, 2015.
Carson KV, Brinn MP, Robertson TA, To-A-Nan R, Esterman AJ, Peters m, et al. Current and Emerging Pharmacotherapeutic Options for Smoking Cessation. Subst Abuse 2013, 7: 85–105.
Campbell S, Bohanna I, Swinbourne A, Cadet-James Y, McKeown D and McDermott R. Stages of Change, Smoking Behaviour and Readiness to Quit in a Large Sample of Indigenous Australians Living in Eight Remote North Queensland Communities. Int. J. Environ. Res. Public Health 2013, 10(4): 1562-71.
Canga N, De Irala J, Vara E, Duaso MJ, Ferrer A and Martínez-González MA. Intervention study for smoking cessation in diabetic patients: a randomized controlled trial in both clinical and primary care settings. Diabetes Care 2000, 23(10):1455-60.
Chen J, Chen Y, Chen P, Liu Z, Luo H and Cai S. Effectiveness of individual counseling for smoking cessation in smokers with chronic obstructive pulmonary disease and asymptomatic smokers. Experi Ther
Med 2014, 7: 716-20.
Ehteshami-Afshar S, Momenan A, Hajshekholeslami F, Azizi F and Hadaegh F. The impact of smoking status on 9.3 years incidence of cardiovascular and all-cause mortality among Iranian men. Ann Hum Biol 2014, 41(3): 249-54
Fagerström KO, Heatherton TF and Kozlowski LT. Nicotine addiction and its assessment. Ear Nose Throat J 1990, 69(11): 763-5.
Fagerström KO, Kunze M, Schoberberger R, Breslau N, Hughes JR, Hurt RD, et al. Nicotine dependence versus smoking prevalence: comparisons among countries and categories of smokers. Tob Control. 1996, 5(1): 52–56.
Gellert C, Schöttker B, Müller H, Holleczek B and Brenner H. Impact of smoking and quitting on cardiovascular outcomes and risk advancement periods among older adults. Eur J Epidemiol. 2013, 28(8): 649-58.
Hur NW, Kim HC, Nam CM, Jee SH, Lee HC and Suha I. Smoking cessation and risk of type 2 diabetes mellitus: Korea Medical Insurance Corporation Study. Eur J Cardiovasc Rehabil 2007, 14(2): 244-9.
Joseph AM, Fu SS, Lindgren B, Rothman AJ, Kodl M, Lando H, et al. Chronic disease management for tobacco dependence: a randomized, controlled trial. Arch Intern Med 2011, 171(21):1894-900.
Land TG, Rigotti NA, Levy DE, Schilling T, Warner D and Li W. The effect of systematic clinical interventions with cigarette smokers on quit status and the rates of smoking-related primary care office visits. PLoS One 2012, 7(7): e41649.
Lovett A, Rakestraw K. A Review of Community Pharmacy-Based Pharmacologic Interventions and Methods for Smoking Cessation. J Pharm Pharmacol 2013, 1(1): 8.
Mallaina P, Lionis C, Rol H, Imperiali R, Burgess A, Nixon M, et al. Smoking cessation and the risk of cardiovascular disease outcomes predicted from established risk scores: Results of the Cardiovascular
Risk Assessment among Smokers in Primary Care in Europe (CV-ASPIRE) Study. BMC Public Health 2013, 13:362.
Novotny TE, Cohen JC, Yurekli A, Sweanor DT, de Beyer J. Smoking cessation and nicotine replacement therapies. In: Jha P, Chaloupka F, eds. Tobacco control in developing countries. New York: Oxford
University Press; 2000:287-310.
Odeberg J, Freitag M, Forssell H, Vaara I, Persson M, Odeberg H, et al. The infl uence of smoking and impaired glucose homoeostasis on the outcome in patients presenting with an acute coronary syndrome:
a cross-sectional study. BMJ Open 2014, 4: e005077.
Partnership for a Tobacco-free Maine. http://www.tobaccofreemaine.org/channels/providers/chronic_diseasepatients.php. Accessed Feb 15, 2015.
Pérez-Tortosa S, Roig L, Manresa JM, Martin-Cantera C, Puigdomènech E, Roura P, et al. Continued smoking abstinence in diabetic patients in primary care: a cluster randomized controlled multicenter
study. Diabetes Res Clin Pract. 2015, 107(1): 94-103.
Prochaska JO and Velicer WF. The trans theoretical model of health behavior change. Am J Health Promot 1997, Sep-Oct;12(1):38-48.
Rajanandh MG, Ramasamy C, Nageswari AD and Ethirajan N. Role of clinical pharmacist in smoking cessation: A prospective randomized trial. Arch Pharm Pract 2012, 3(4): 254-9.
Steinberg MB, Schmelzer AC, Lin PN and Gadiz Garcia. Smoking as a Chronic Disease. Curr Cardio Risk Res 2010, 4; 413-20.
Thankappan KR, Mini GK, Daivadanam M, Vijayakumar G, Sarma PS and Nichter M. Smoking cessation among diabetes patients: results of a pilot randomized controlled trial in Kerala, India. BMC Public Health 2013, 13:47.
Takata K, Imaizumi S, Kawachi E, Suematsu Y, Shimizu T, Abe S, et al. Impact of Cigarette Smoking Cessation on High-Density Lipoprotein Functionality. Circulation 2014, 78: 2955-62.
The Tobacco Use and Dependence Clinical Practice Guideline Panel, Staff, and Consortium Representatives. A Clinical Practice Guideline for Treating Tobacco Use and Dependence A US Public Health Service
Report. JAMA 2000, 283(24) (Reprinted): 3244-54.
Thomas D, Abramson MJ, Bonevski B, Taylor S, Susan Poole S, Weeks GR, et al. A pharmacist-led system-change smoking cessation intervention for smokers admitted to Australian public hospitals (GIVE UP FOR GOOD): study protocol for a randomised controlled trial. Trials 2013, 14:148.
Vermaa A, Harrisona A, Toruna P, Vestbob J, Edwardsc R and Thorntona J. Are pharmacists reducing COPD’S impact through smoking cessation and assessing inhaled steroid use? Respiratory Med 2012, 106: 230-4.
Virdis A, Giannarelli C, Neves MF, Taddei S and Ghiadoni L. Cigarette smoking and hypertension. Curr Pharm Des. 2010; 16(23): 2518-25.
World Health Organization Tobacco. Available at http://www.who.int/mediacentre/factsheets/fs339/en/. Updated 2015, Accessed Feb 15, 2015.
World Heart Federation. Cardiovascular disease risk factors. http://www.world-heart-fed-eration.org/cardiovascular-health/cardiovascular-disease-risk-factors. Updated 2014, Accessed Feb 15, 2015.
Wu J and Don D Sin DD. Improved patient outcome with smoking cessation: when is it too late? Int J Chron Obstruct Pulmon Dis 2011, 6: 259–67.