Introduction Hospitalization and post-discharge provide an opportune time for tobacco cessation. This study tested the feasibility, uptake, and cessation outcomes of a hospital-based tobacco cessation program, delivered by volunteers to the bedside with post-discharge referral to Quitline services. Patient characteristics associated with Quitline uptake and cessation were assessed. Methods Between February and November 2016, trained hospital volunteers approached inpatient tobacco users on six pilot units. Volunteers shared a cessation brochure and used the ASK-ADVISE-CONNECT model to connect ready to quit patients to the Delaware Quitline via fax-referral. Volunteers administered a follow-up survey to all admitted tobacco users via telephone or email at 3-months post-discharge. Results Of the 743 admitted tobacco users, 531 (72%) were visited by a volunteer, and 97% (531/547) of those approached, accepted the visit. Over one-third (201/531; 38%) were ready to quit and fax-referred to the Quitline, and 36% of those referred accepted Quitline services. At 3 months post-discharge, 37% (135/368) reported not using tobacco in the last 30 days; intent-to-treat cessation rate was 18% (135/743). In a multivariable regression model of Quitline fax-referral completion, receiving nicotine replacement therapy (NRT) during hospitalization was the strongest predictor (odds ratios [OR] = 1.97; 95% confidence interval [CI] = 1.34 to 2.90). In a model of 3-month cessation, receiving Quitline services (OR = 3.21, 95% CI = 1.35 to 7.68) and having coronary artery disease (OR = 2.28; 95% CI = 1.11 to 4.68) were associated with tobacco cessation, but a volunteer visit was not. Conclusions An “opt-out” tobacco cessation service using trained volunteers is feasible for connecting patients to Quitline services. Implications This study demonstrates the feasibility of a systems-based approach to link inpatients to evidence-based treatment for tobacco use. This model used trained bedside volunteers to connect inpatients to a state-funded Quitline after discharge that offers free cessation treatment of telephone coaching and cessation medications. Receiving NRT during hospitalization positively impacted Quitline referral, and engagement with Quitline resources was critical to tobacco abstinence post-discharge. Future work is needed to evaluate the cost-effectiveness and sustainability of this volunteer model.

Propensity score methods are increasingly used as a tool to control for confounding bias in pharmacoepidemiologic studies. The propensity score is a dimension reducing balancing score, creating treatment, and reference groups that have comparable distributions of measured covariates. The purpose of this methods review is to provide an overview of the use of propensity score methods, including a summary of important data assumptions, various applications of the propensity score, and how to evaluate covariate balance. This article is intended for pharmacists and researchers who wish to receive an introduction to propensity score methods and be able to engage in high-level discussions on application and reporting.

Background: There continues to be controversy regarding the simultaneous encouragement of both breastfeeding and immediate postpartum contraception. Research Aim: To explore postpartum women’s perspectives about breastfeeding and their breastfeeding behaviors, while using one of three different hormonally systemic contraceptive methods immediately postpartum over a 6 month period of time. Methods: This was a retrospective, longitudinal, three group comparative, secondary analysis of a prospective cohort study ( N = 471) of immediate postpartum contraception. Breastfeeding, for this study, was defined as providing any human milk to the infant. Participants who chose one of three different hormonally systemic forms of contraception immediately postpartum (a long-acting hormonal reversible contraceptive ( n = 200), depot medroxyprogesterone acetate 150 mg ( n = 98), or a non-hormonal method ( n = 173)) were compared at hospital discharge, 6 weeks, 3 months, and 6 months postpartum. The primary outcome was any breastfeeding at 6 months. Secondary outcomes included any and exclusive breastfeeding, concerns about breastfeeding while using contraception, and reasons for breastfeeding discontinuation. Results: There was no significant difference in the rate of any breastfeeding between the two hormonal and the non-hormonal contraceptive groups at 6 months postpartum (long-acting hormonal 20.1%, non-hormonal 21.7%, depot medroxyprogesterone acetate 13.9%, p = .77, 0.28, respectively). The number of participants who reported stopping breastfeeding due to decreased milk supply was not significantly different between any groups at all time points (total number who discontinued at 6 months postpartum was long-acting hormonal 24.7%, non-hormonal 25.1%, depot medroxyprogesterone acetate 19.3%, p = .30). Conclusions: Breastfeeding perspectives and behavioral outcomes over the first 6 months postpartum were not influenced by participants chosen form of immediate postpartum contraception.

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month after discharge is 58%, and rapidly decreased to 22% three months later. Most of the patients (73.1%) were classified in to non-adherent (MPR< 40%), 20.5% patients adherence were medium (40%≤ MPR< 80%), only 6.4% patients adherence were good (MPR≥ 80%).It is found that gender, hospital level, medical history, comorbidities have significant association with statin adherence. In recursive partitioning analysis, patients combined with specific characteristics (no-diabetes & female & nohypertension) have poorest statin adherence. While in another subgroup (patients combined diabetes and some other CVD & treated in high-level hospitals) statin adherence was best. ConCluSionS: Statin adherence in Chinese ASCVD patients was very poor compared with developed countries. It is urgent to take actions to improve the status. Physicians and patients education may be important and effective way to be carried out.