Implementation of a smoking cessation initiative delivered by pharmacy students on an in-patient Vascular Surgery unit: a pilot program evaluation

Abstract

Background: Standardized nurse-led smoking cessation programs, such as The Ottawa Model for Smoking Cessation (OMSC®), have demonstrated efficacy and feasibility in multiple healthcare settings. Pharmacy students have the potential to deliver this program in lieu of other healthcare professionals. Objectives: To evaluate the successes and challenges of a modified OMSC® program pharmacy students as smoking cessation counsellors on a Vascular Surgery inpatient unit. The primary outcome is reach; secondary outcomes are implementation and effectiveness. Methods: A pilot program was initiated with nurses systematically identifying smokers and consulting pharmacy for smoking cessation counselling. Pharmacy students completed smoking cessation consults and offered post-discharge support through the OMSC® program. Smoking prevalence and identification rates were collected from the electronic medical record and smoking quit rates at 3-months post-discharge were obtained from the OMSC® database. Results: A total of 672 patients were admitted during the program evaluation period, with 169 documented smokers and a smoking prevalence rate of 25%. Unit nurses ordered 124 smoking cessation consultations of which 102 (82%) were completed by the pharmacy student, reaching a total of 60% (102/169) of all documented smokers. Sixty-nine patients agreed to follow-up support, 37 of whom remained in the program at 3-months post-discharge. Using an intention-to-treat analysis, 28% of patients were smoke-free and 12% had reduced the amount they smoke at 3-months. Conclusions: Program feasibility was demonstrated with the pharmacy student completing a majority (82%) of ordered smoking cessation consultations and reaching a significant proportion of documented smokers. Routinization of new practices and continuous reinforcement from onsite program champions are required to ensure program sustainability and continued success.