Feasibility, uptake and impact of a hospital-wide tobacco addiction treatment pathway: Results from the CURE project pilot

Evison, Matthew; Pearse, Cheryl; Howle, Freya; Baugh, Monique; Huddart, Helen; Ashton, Eileen; Rutherford, Michael; Kearney, Carol; Elsey, Lyn; Staniforth, Darren; Hoyle, Kathryn; Raja, M. Krishna; Jerram, J. C. K.; Regan, David G.; Booton, Richard; Britton, John; O'Rourke, Colin; Shackley, David; Benbow, Liz; Crossfield, Andrea; Pilkington, Jayne; Bailey, Mandy; Preece, Richard

doi:10.7861/clinmed.2019-0336

Cited by 21 publications

(37 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Over one in five of all smokers admitted during the pilot period reported abstinence from smoking 12 weeks after discharge. 7 Asked to sum up the most important lesson for other hospitals to learn from the CURE programme, Dr Evison says: "It's the medical leadership. The intervention is not complicated: it needs to be coupled with the behavioural intervention and funded properly so the whole thing is as one.…”

Section: Effective Managementmentioning

confidence: 99%

See 1 more Smart Citation

The CURE Project: improving NHS smoking cessation services

Ogden¹

2020

Prescriber

View full text Add to dashboard Cite

Although there have been modest advances in NHS smoking cessation services over the past few years, there is still more work to be done. This article discusses the progress of the CURE Project, a new approach to tackling tobacco addiction based on the Canadian Ottawa Model for Smoking Cessation and first pioneered in the UK in Greater Manchester, which aims to systematically identify all active smokers admitted to hospital and immediately offer them treatment.

show abstract

Section: Effective Managementmentioning

confidence: 99%

“…Of these, 96% were given very brief advice (VBA) to quit, 66% were prescribed smoking cessation pharmacotherapy, and 61% received a behavioural change intervention from a specialist cessation practitioner. Over one in five of all smokers admitted during the pilot period reported abstinence from smoking 12 weeks after discharge 7 …”

Section: Effective Managementmentioning

confidence: 99%

The CURE Project: improving NHS smoking cessation services

Ogden¹

2020

Prescriber

View full text Add to dashboard Cite

show abstract

“…Patients are then attached to ongoing community follow-up post-discharge [6]. Aligned with this approach, the CURE project aims for cultural change within the secondary care context, encouraging healthcare providers to view tobacco dependence as a disease to be treated, rather than a lifestyle choice [7,8]. In line with the OMSC, both existing secondary-care staff and a specialist nursing team deliver different aspects of the intervention.…”

Section: Introductionmentioning

confidence: 99%

“…The CURE project appears both feasible and effective [6,7]. Although only in the early stages, preliminary evidence from the CURE project pilot highlights 22% of smokers admitted during the pilot phase reported abstinence at 12 weeks post discharge [7]. Evaluation of the OMSC suggests this model of smoking cessation may also be successful in improving health outcomes more broadly [6].…”

Section: Introductionmentioning

confidence: 99%

Barriers and facilitators to implementing the CURE stop smoking project: a qualitative study

Wearn

Haste

Haighton

et al. 2021

BMC Health Serv Res

View full text Add to dashboard Cite

Background The Conversation, Understand, Replace, Experts and evidence-based treatment (CURE) project aims to provide a comprehensive offer of both pharmacotherapy and specialist support for tobacco dependence to all smokers admitted to hospital and after discharge. CURE was recently piloted within a single trust in Greater Manchester, with preliminary evidence suggesting this intervention may be successful in improving patient outcomes. Plans are currently underway to pilot a model based upon CURE in other sites across England. To inform implementation, we conducted a qualitative study, which aimed to identify factors influencing healthcare professionals’ implementation behaviour within the pilot site. Methods Individual, semi-structured telephone interviews were conducted with 10 purposively sampled health professionals involved in the delivery and implementation of the CURE project pilot. Topic guides were informed by the Theoretical Domains Framework (TDF). Transcripts were analysed in line with the framework method, with data coded to TDF domains to highlight important areas of influence and then mapped to the COM-B to support future intervention development. Results Eight TDF domains were identified as important areas influencing CURE implementation; ‘environmental context and resources’ (physical opportunity), ‘social influence’ (social opportunity), ‘goals’, ‘professional role and identity’ and ‘beliefs about consequences’ (reflective motivation), ‘reinforcement’ (automatic motivation), ‘skills’ and ‘knowledge’ (psychological capability). Most domains had the potential to both hinder and/or facilitate implementation, with the exception of ‘beliefs about consequences’ and ‘knowledge’, which were highlighted as facilitators of CURE. Participants suggested that ‘environmental context and resources’ was the most important factor influencing implementation; with barriers most often related to challenges integrating into the wider healthcare context. Conclusions This qualitative study identified multi-level barriers and facilitators to CURE implementation. The use of theoretical frameworks allowed for the identification of domains known to influence behaviour change, and thus can be taken forward to develop targeted interventions to support future service implementation. Future work should focus on discussing these findings with a broad range of stakeholders, to ensure resultant intervention strategies are feasible and practicable within a healthcare context. These findings complement wider evaluative work to support nationwide roll out of NHS funded tobacco dependence treatment services in acute care trusts.

show abstract

“…3 Evison and colleagues from Manchester report on the CURE project, the first UK service modelled on the Ottawa Model for Smoking Cessation. 4 A feature of the model is that secondary care clinicians are at the frontline in the delivery of treatment, of especial importance since the NHS 10-year plan commits to funding the treatment of Think national, act local: the role of the physician and the RCP tobacco addiction in hospitals. The CURE project provides a potential framework for national roll out of such services, and we are delighted to present the impact of the study in the first 6 months of service.…”

mentioning

confidence: 99%

Think national, act local: the role of the physician and the RCP

Emmanuel¹

2020

Clinical Medicine

View full text Add to dashboard Cite

Decision making in medicine is informed by a subtle mixture of factors: education, experience, local protocols, gut feeling, avoiding litigation. The principle of audit is that one can influence practice also by reflecting back personal performance measured against standardised averages or formal guidance. Mitchell and colleagues highlight some of the challenges herein in their analysis of computed tomography in acute presentations with epilepsy. 1 They develop the findings of a recent national audit in the UK in selected cohorts of such patients which identified that as many as one in five patients with known epilepsy had scans following presentation to the emergency department. Many of you reading this are involved with such acute medicine presentations. They present a population level analysis over a 3-year period to identify patient factors associated with the rate of scanning. The potential of this to influence management algorithms and practice is discussed elegantly.The theme of developing local policy by using national datasuch as the Hospital Episode Statistics (HES) -is developed in the paper by Soong et al . 2 Frailty is a common condition with a potentially significant health impact among older adults. To date, it is not known whether stratifying by degrees of frailty can help plan care and result in improved outcomes. In a retrospective observational study, the authors report the predictive ability of routinely coded 'frailty syndromes' to predict long length of stay and mortality in a 1-year sample of patients over the age of 65. Frailty is of relevance to generalists, given the previous finding by the same group that the majority of hospital admission patients have at least one of these frailty syndromes.Clinical Medicine is proudly a journal of the Royal College of Physicians (RCP), and is delighted to showcase topics that are of interest to the RCP. One of these is the need for NHS-based tobacco addiction services, as highlighted in the RCP report Hiding in plain sight: Treating tobacco dependency in the NHS which called for a new model of care providing 'opt-out' specialist services to treat the condition. 3 Evison and colleagues from Manchester report on the CURE project, the first UK service modelled on the Ottawa Model for Smoking Cessation. 4 A feature of the model is that secondary care clinicians are at the frontline in the delivery of treatment, of especial importance since the NHS 10-year plan commits to funding the treatment of Think national, act local: the role of the physician and the RCP tobacco addiction in hospitals. The CURE project provides a potential framework for national roll out of such services, and we are delighted to present the impact of the study in the first 6 months of service.Another national, indeed global, health crisis -much more acute -is the ongoing outbreak of the novel coronavirus disease . The RCP, and its journals, are able to respond in nimble fashion with an update on the evolving outbreak, its clinical manifestations and the priorities for the immediate ...

show abstract

Feasibility, uptake and impact of a hospital-wide tobacco addiction treatment pathway: Results from the CURE project pilot

Cited by 21 publications

References 12 publications

The CURE Project: improving NHS smoking cessation services

The CURE Project: improving NHS smoking cessation services

Barriers and facilitators to implementing the CURE stop smoking project: a qualitative study

Think national, act local: the role of the physician and the RCP

Contact Info

Product

Resources

About