How can hospitals change practice to better implement smoking cessation interventions? A systematic review

Ugalde, Anna; White, Victoria; Rankin, Nicole; Paul, Christine; Segan, Catherine; Aranda, Sanchia; Shee, Anna Wong; Hutchinson, Alison; Livingston, Patricia M.

doi:10.3322/caac.21709

Cited by 27 publications

(31 citation statements)

References 104 publications

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“…Strategies used to implement the survivorship program were coded against principles of management (Planning, Organising, Leading, Monitoring) [11] and external In uences as outlined in a previous systematic review [12]. Table 1 provides a detailed summary of the domain-speci c strategies used to implement the survivorship program.…”

Section: Implementation Of the Survivorship Programmentioning

confidence: 99%

Implementation of a referral pathway for cancer survivors to access allied health services in the community

Russell

McIntosh²,

Martín³

et al. 2023

Preprint

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Background The growing demands for multidisciplinary cancer survivorship care require new approaches to address the needs of people living after a cancer diagnosis. Good Life–Cancer Survivorship is a self-management support survivorship program delivered by community allied health (AH) services for people diagnosed with cancer. A pilot study established the benefits of Good Life–Cancer Survivorship to help survivors manage their health and wellbeing in the community health setting. This study expanded the program to four community health services and evaluated the implementation outcomes of the survivorship program. Methods Eligible cancer survivors attending hospital oncology services were referred to the survivorship program. Data was collected between 19/02/2021-22/02/2022 and included allied health service utilisation, consumer surveys, and interviews to understand consumer experience with the survivorship program. Interviews and focus groups with hospital and community health professionals explored factors influencing the survivorship program uptake. Implementation outcomes included Adoption, Acceptability, Appropriateness, Feasibility, and Sustainability. Results Of 35 eligible survivors (mean age 65.5 years, SD=11.0; 56% women), 31 (89%) accepted the referral. Most survivors had two (n=14/31; 45%) or more (n=11/31; 35%) allied health needs. Of 162 AH appointments (median appointment per survivor=4; range=1-15; IQR:5), 142/162 (88%) were scheduled within the study period and 126/142 (89%) were attended. Consumers’ interviews (n=5) discussed the referral pathway; continuation of survivorship care in community health settings; opportunities for improvement of the survivorship program. Interviews with community health professionals (n=5) highlighted the impact of the survivorship program; cancer survivorship care in community health; sustainability of the survivorship program. Interviews (n=3) and focus groups (n=7) with hospital health professionals emphasised the importance of a trusted referral process; a holistic and complementary model of care; a person-driven process; the need for promoting the survivorship program. All evaluations favourably upheld the five implementation outcomes. Conclusions The Good Life–Cancer Survivorship program supported survivors in self-management strategies through accessible and tailored community allied health services. The survivorship program was well adopted and demonstrated acceptability, appropriateness, and feasibility by all parties involved. Findings support the delivery of cancer survivorship care in community health settings with recommendations from clinicians to sustain the referral pathway.

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Section: Implementation Of the Survivorship Programmentioning

confidence: 99%

Implementation of a referral pathway for cancer survivors to access allied health services in the community

Russell

McIntosh²,

Martín³

et al. 2023

Preprint

Self Cite

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“…Hospitals may struggle to embed smoking cessation into routine care, both generally and in cancer clinics. In a systematic review of 63 studies investigating the implementation of smoking cessation in hospital settings, the focus on staff training outweighed efforts in planning, allocation of resources and delegation of tasks [ 27 ]. In a qualitative study with hospital staff, interviews in rural, regional and metropolitan hospitals identified concerns about lack of time to deliver smoking cessation therapy, the need for clearer policies, for better training and for consistent messaging [ 28 ].…”

Section: Tobacco Treatment In Cancer Clinics and Hospital Settingsmentioning

confidence: 99%

The Tobacco Endgame—A New Paradigm for Smoking Cessation in Cancer Clinics

Paul

2022

Current Oncology

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Smoking cessation represents an untapped resource for cancer therapy. Many people who smoke and have cancer (tobacco-related or otherwise) struggle to quit and as a result, jeopardise response to treatment, recovery after surgery and long-term survival. Many health care practitioners working in cancer medicine feel undertrained, unprepared and unsupported to provide effective smoking cessation therapy. Many institutions and healthcare systems do provide smoking cessation programs, guidelines and referral pathways for cancer patients, but these may be unevenly applied. The growing body of evidence, from both retrospective and prospective clinical studies, confirms the benefit of smoking cessation and will provide much needed evidence for the best and most effective interventions in cancer clinics. In addition to reducing demand, helping cancer patients quit and treating addiction, a firm commitment to developing smoke free societies may transform cancer medicine in the future. While the Framework Convention for Tobacco Control (FCTC) has dominated global tobacco control for the last two decades, many jurisdictions are starting to develop plans to make their communities tobacco free, to introduce the tobacco endgame. Characterised by downward pressure on tobacco supply, limited sales, limited access and denormalization of smoking, these policies may radically change the milieu in which people with cancer receive treatment, in which health care practitioners refine skills and which may ultimately foster dramatic improvements in cancer outcomes.

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“…Moreover, the funding mechanism of the facility and ISCI was not explicit and did not include any qualitative data reflecting participants' perspectives on the ISCIs, and the SR has yet to be updated. Ugalde et al [10] conducted a SR on ISCI implementation strategies and their success evaluating outcomes. The authors highlighted the need for qualitative data to provide depth and understanding of the clinical and patient experience.…”

Section: Introductionmentioning

confidence: 99%

“…In addition, Sharpe et al [11] conducted their SR on barriers to the provision of ISCIs from clinicians' perspectives and, however, did not include patient perspectives or a broader range of staff perspectives. Therefore, in order to complement and build on the work of Rigotti et al [6], Sharpe et al [11], and Ugalde et al [10], this qualitative integrative review (IR) of the literature focusing on staff and participants' perspectives of ISCIs will provide the reader with a broader understanding of potential contributing factors to the success or failure of ISCIs and therefore further insight in to the processes that lead to the outcome of this kind of intervention.…”

Section: Introductionmentioning

confidence: 99%

Hospitalised Smokers’ and Staff Perspectives of Inpatient Smoking Cessation Interventions and Impact on Smokers’ Quality of Life: An Integrative Review of the Qualitative Literature

et al. 2023

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Aim. To identify, integrate, and appraise the evidence on hospitalised smokers’ and staff perspectives of inpatient smoking cessation interventions and the impact on smokers’ quality of life. Design. The integrative review method was used to present hospitalised smokers’ and staff perspectives of inpatient smoking cessation interventions. Search Method. This integrative review consisted of a comprehensive search on smoking cessation interventions that take place during an inpatient admission to hospital for adults (> age 18 years) of the following online databases: Ovid Medline, Joanna Briggs Institute, APA PsycInfo, CINAHL, Cochrane, Google Scholar, PEDro, and Scopus. The search strategy was inclusive of peer-reviewed studies limited to the English language or translated to English. A search of grey literature and manual searching of reference lists was also conducted to identify further studies not identified in the online database search. All studies that produced any qualitative data (i.e., qualitative, mixed methods, and surveys) on inpatient-initiated smoking cessation programs were included. Outcomes of interest are included but were not limited to education, counselling, and the use of pharmacotherapy. Studies undertaken in the psychiatric, adolescent, and paediatric settings were excluded. Results. The key findings from this integrative review included positive evaluations from both patients and staff involved in inpatient smoking cessation interventions, reporting that hospitalisation was an appropriate opportunity to address smoking cessation. A number of facilitators and barriers to inpatient smoking cessation interventions included creating a supportive patient-centred environment and consideration of the cost of nicotine replacement therapy and time to deliver inpatient smoking cessation interventions. Recommendations/preferences for future inpatient smoking cessation interventions included the use of a program champion and ongoing education to demonstrate the effectiveness of the intervention, and despite the cost of nicotine replacement therapy being identified as a potential barrier, it was identified as a preference for most patients. Although quality of life was only evaluated in two studies, statistically significant improvements were identified in both. Conclusion. This qualitative integrative review provides further insight into both clinician and patient participants’ perspectives on inpatient smoking cessation interventions. Overall, they are seen to produce positive benefits, and staff training appears to be an effective means for service delivery. However, insufficient time and lack of resources or expertise appear to be consistent barriers to the delivery of these services, so they should be considered when planning the implementation of an inpatient smoking cessation intervention.

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How can hospitals change practice to better implement smoking cessation interventions? A systematic review

Cited by 27 publications

References 104 publications

Implementation of a referral pathway for cancer survivors to access allied health services in the community

Implementation of a referral pathway for cancer survivors to access allied health services in the community

The Tobacco Endgame—A New Paradigm for Smoking Cessation in Cancer Clinics

Hospitalised Smokers’ and Staff Perspectives of Inpatient Smoking Cessation Interventions and Impact on Smokers’ Quality of Life: An Integrative Review of the Qualitative Literature

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