Patient receipt of smoking cessation care in four Australian acute psychiatric facilities

Metse, A.P.; Wiggers, John; Wye, Paula; Bowman, Jenny

doi:10.1111/inm.12459

Cited by 5 publications

(6 citation statements)

References 27 publications

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“…Previous research in psychiatry settings reported the routine provision of brief smoking cessation advice at moderate levels and smoking status documentation as low as 50%, even after implementing system change interventions, intensive staff training and highly targeted smoking cessation interventions (Lappin et al, 2020;Metse et al, 2018;Prochaska et al, 2004;Williams et al, 2015;Wye et al, 2009Wye et al, , 2010Wye et al, , 2017Young et al, 2022). However, our study found high smoking status documentation (88%) prior to the system change intervention, likely related to new laws in 2015 that prohibited smoking at Queensland hospitals, which motivated improved smoking status documentation for inpatients and development of the Pathway.…”

Section: Discussionmentioning

confidence: 99%

“…Hospital admissions present an opportunity to deliver smoking cessation interventions (Rigotti et al, 2012) and psychiatry inpatient units are uniquely positioned to support people with SMI who smoke with evidence-based smoking cessation assistance. However, smoking cessation is not routinely provided in general hospital settings (Agrawal and Mangera, 2016), and smoking cessation assistance has been reported as inconsistent, delayed and inadequately delivered in psychiatry inpatient units (Bailey et al, 2019; Kagabo et al, 2020; Metse et al, 2018; Wye et al, 2010). Psychiatry services have traditionally had a permissive approach to smoking (Lawn and Campion, 2013; Ratschen et al, 2018; Sharma et al, 2018; Sheals et al, 2016), with many mental health clinicians reluctant to treat smoking or acknowledge the importance of addressing smoking for people with SMI (Sharma et al, 2018; Sheals et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

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Can improvement in delivery of smoking cessation care be sustained in psychiatry inpatient settings through a system change intervention? An analysis of statewide administrative health data

Plever

Kisely

Bonevski

et al. 2023

Aust N Z J Psychiatry

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Objective: This study evaluated maintenance of improved delivery of smoking cessation assistance in adult acute psychiatry inpatient units 3 years post statewide implementation of a system change intervention through analysis of a statewide administrative health dataset. Method: Rates of documenting smoking status and providing a brief smoking cessation intervention (the Smoking Cessation Clinical Pathway) in all eligible Queensland public adult acute psychiatry inpatient units ( N = 57) during the implementation phase (October 2015–September 2017) of a system change intervention were compared to the maintenance phase (October 2017–October 2020) using interrupted time series analysis. Results: Across implementation and maintenance phases, the percentage of discharges from psychiatry inpatient units that had a smoking status recorded remained high with the statewide average exceeding 90% (implementation phase 93.2%, 95% confidence interval = [92.4, 93.9]; and maintenance phase 94.6%, 95% confidence interval = [94.0, 95.2]). The percentage of discharges statewide with a completed Pathway stabilised during the maintenance phase (change in slope −3.7%, 95% confidence interval = [−5.2, −2.3]; change in level 0.4%, 95% confidence interval = [−7.0, 7.9]). Conclusion: An evidence-based smoking cessation intervention implemented with a system change intervention resulted in sustained improvement in addressing smoking in adult inpatient psychiatry units up to 3 years post implementation.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Can improvement in delivery of smoking cessation care be sustained in psychiatry inpatient settings through a system change intervention? An analysis of statewide administrative health data

Plever

Kisely

Bonevski

et al. 2023

Aust N Z J Psychiatry

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“…This is unfortunate, as there are a number of treatment options which have been found to be effective for patients in mental health facilities. For example, Metse et al (2018) reported that nicotine replacement therapy was effective according to most psychiatric patients who received it [ 52 ]. According to Keizer et al (2019), motivational enhancement interventions were successful in reducing patients’ tobacco withdrawal symptoms [ 53 ].…”

Section: Discussionmentioning

confidence: 99%

Nurses’ Perspectives on Smoking Policies, Safety and Cessation Support in Psychiatric Wards: A Cross-Sectional Survey

Chawłowska¹,

Karasiewicz²,

Marcinkowska³

et al. 2022

Healthcare

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A high prevalence of smoking and low rates of smoking cessation interventions can be observed in psychiatric wards. A questionnaire-based, cross-sectional study was performed in five hospitals among 107 psychiatric ward nurses. The aim was to investigate nurses’ views on patients’ smoking practices and their influence on the safety of both the patients and medical personnel. In addition, we asked about the availability of smoking cessation support. Most of the respondents noticed the negative impacts of smoking on patients and medical personnel. Nearly a third of our respondents (29.0%) recalled smoking-related accidents in their facilities. In 45.2% of these accidents, a patient set someone else on fire. Around one fifth of nurses had rather permissive attitudes towards tobacco use in hospital wards. Significant associations were identified between respondents’ smoking status and their opinions on amending smoking policies and on unsupervised smoking. Regarding professional help available to smoking patients, 88.8% of participants reported that interventions to address smoking were available in their wards. Psychiatric hospitalisation can be an opportunity to offer tobacco treatment to patients with mental health conditions. To make use of this opportunity, smoke-free policies need to be put in place and hospital personnel, particularly nurses, should be trained and equipped with the knowledge and skills needed to assist in the smoking care of psychiatric ward patients.

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“…While this is an improvement on other reported rates closer to 50% (Slattery et al, 2016;Wye et al, 2017), it still leaves an unacceptable number of smokers not being treated. Lack of systematic application, challenges in administrative burden and ongoing staff resistance to providing smoking care have been implicated in patients not receiving smoking care (Huddlestone et al, 2018;Koplan et al, 2008;Metse et al, 2018;Wye et al, 2017). The current initiative used an existing hospital clinical pathway to minimise additional administrative effort but also support staff with varying capability levels.…”

Section: Discussionmentioning

confidence: 99%

Queensland smoking care in adult acute mental health inpatient units: Supporting practice change

Plever¹,

McCarthy²,

Anzolin³

et al. 2020

Aust N Z J Psychiatry

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Objective: To review a clinical practice improvement approach to statewide implementation of smoking care in adult acute mental health inpatient units across public mental health services in Queensland. Method: Queensland public mental health services, with adult acute inpatient units, joined a statewide collaborative to work together to increase the routine screening of smoking and delivery of a Smoking Cessation Clinical Pathway brief intervention to identified smokers. Results: Over a 2-year period, statewide improvements were demonstrated in the recording of smoking status (88–97%) and in the provision of a brief smoking cessation intervention to smokers (38–73%). In addition, all individual mental health services increased the delivery of a brief intervention to identified smokers and the recording of smoking status either improved or remained at high levels. Conclusion: Smoking remains an ongoing challenge for mental health services and one of the most important physical health issues for people living with a mental illness. The ability to implement statewide smoking care in public mental health services is an important step in shifting poor health outcomes. The clinical practice change approach adopted in Queensland has demonstrated encouraging outcomes in improving the delivery of smoking care that has been sustained over a 2-year period.

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Patient receipt of smoking cessation care in four Australian acute psychiatric facilities

Cited by 5 publications

References 27 publications

Can improvement in delivery of smoking cessation care be sustained in psychiatry inpatient settings through a system change intervention? An analysis of statewide administrative health data

Can improvement in delivery of smoking cessation care be sustained in psychiatry inpatient settings through a system change intervention? An analysis of statewide administrative health data

Nurses’ Perspectives on Smoking Policies, Safety and Cessation Support in Psychiatric Wards: A Cross-Sectional Survey

Queensland smoking care in adult acute mental health inpatient units: Supporting practice change

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