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Browsing by Subject "Tobacco cessation"
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Item Community Pharmacy Technicians’ Engagement in the Delivery of Brief Tobacco Cessation Interventions: Results of a Randomized Trial(Elsevier, 2022) Corelli, Robin L.; Merchant, Kyle R.; Ellis Hilts, Katy; Kroon, Lisa A.; Vatanka, Parisa; Hille, Brian T.; Suchanek Hudmon, Karen; School of NursingBackground: In recent years, the role of community pharmacy technicians has expanded to include involvement in the provision of brief tobacco cessation interventions. While technicians appear to be a key component in this service, their level of engagement and associated perceptions of this new role have not been described. Objective: To compare pharmacy technicians' frequency of involvement in brief tobacco cessation interventions delivered in a community pharmacy setting, as a function of training approach, and to characterize their perceptions of this expanded role, including barriers to implementation. Methods: Twenty California-based grocery store chain pharmacies were randomized to receive (a) written training materials-only [minimal] or (b) written training materials plus live training with coaching and active monitoring by pharmacy management [intensive]. After written materials were distributed to the sites, tobacco cessation interventions were documented prospectively for 12 weeks post-training. Results: Over the 12-week study, technicians (n = 50) documented their involvement in 524 interventions (57.7% of 908 total), with the minimal group accounting for 56.1% and the intensive group accounting for 43.9% (p < 0.001). The number of individual technicians who reported at least one intervention was 16 (of 26; 61.5%) in the minimal group and 24 (of 24; 100%) in the intensive group (p < 0.001). At the conclusion of the study, 100% of technicians in the intensive group self-rated their ability to interact with patients about quitting smoking as good, very good, or excellent compared to 73.9% in the minimal group (p = 0.10). Conclusion: In both study arms, technicians documented high numbers of tobacco cessation interventions. The higher proportion of technicians providing one or more interventions in the intensive group suggests a greater overall engagement in the process, relative to those receiving minimal training. Technicians can play a key role in the delivery of tobacco cessation interventions in community pharmacies.Item Effects of smoke-free air law on acute myocardial infarction hospitalization in Indianapolis and Marion County, Indiana(BMC Public Health, 2018-02-09) Weaver, Anne M.; Wang, Yi; Rupp, Katelin; Watson, Dennis P.Background A comprehensive smoke-free air law was enacted on June 1, 2012 in most of Marion County, Indiana, including all of the City of Indianapolis. We evaluated changes in acute myocardial infarction (AMI) admission rates in Indianapolis and Marion County before compared to after the law. Methods We collected AMI admissions from five Marion County hospitals between May 2007 and December 2014. We used Poisson regression to evaluate the overall effects of the law on monthly AMI hospitalizations, adjusting for month, seasonality, meteorology, air pollution, and hospital utilization. We tested the interactions between the law and AMI risk factors on monthly AMI admission rates to identify subpopulations for which the effects might be stronger. Results Monthly AMI admissions declined 20% (95% CI 14–25%) in Marion County and 25% (95% CI 20–29%) in Indianapolis after the law was implemented. We observed decreases among never (21%, 95% CI 13–29%), former (28%, 95% CI 21–34%), and current smokers (26%, 95% CI 11–38%); Medicaid beneficiaries (19%, 95% CI 9–29%) and non-beneficiaries (26%, 95% CI 20–31%). We observed decreases among those with a history of diabetes (Yes: 22%, 95% CI 14–29%; No: 25%, 95% CI 18–31%), congestive heart failure (Yes: 23%, 95% CI 16–30%; No: 24%, 95% CI 17–31%), and hypertension (Yes: 23%, 95% CI 17–28%: No: 26%, 95% CI 15–36%). Conclusions We observed decreases in AMI admissions comparable with previous studies. We identified subpopulations who benefitted from the law, such as former and current smokers, and those without comorbidities such as congestive heart failure and hypertension.Item Implementing Brief Tobacco Cessation Interventions in Community Pharmacies: An Application of Rogers’ Diffusion of Innovations Theory(MDPI, 2022-05-30) Hilts, Katy Ellis; Corelli, Robin L.; Prokhorov, Alexander V.; Zbikowski, Susan M.; Zillich, Alan J.; Hudmon, Karen Suchanek; Health Policy and Management, School of Public HealthPharmacists, as highly accessible members of the healthcare team, have considerable potential to address tobacco use among patients. However, while published data suggest that pharmacists are effective in helping patients quit, barriers exist to routine implementation of cessation services in community pharmacy settings. Within the context of a randomized trial (n = 64 pharmacies), surveys were administered over a period of 6 months to assess pharmacists' perceptions of factors associated with the implementation of "Ask-Advise-Refer", a brief intervention approach that facilitates patient referrals to the tobacco quitline. Study measures, grounded in Rogers' Diffusion of Innovations Theory, assessed pharmacists' perceptions of implementation facilitators and barriers, perceptions of intervention materials provided, and perceived efforts and personal success in implementing Ask-Advise-Refer at 6-months follow-up. Findings indicate that while the brief intervention approach was not difficult to understand or implement, integration into normal workflows presents greater challenges and is associated with overall confidence and implementation success. Lack of time was the most significant barrier to routine implementation. Most (90.6%) believed that community pharmacies should be active in promoting tobacco quitlines. Study results can inform future development of systems-based approaches that lead to broad-scale adoption of brief interventions, including but not limited to tobacco cessation, in pharmacy settings.Item Long-term evaluation of a train-the-trainer workshop for pharmacy faculty using the RE-AIM framework(Elsevier, 2021-09) Elkhadragy, Nervana; Corelli, Robin L.; Zillich, Alan J.; Campbell, Noll L.; Suchanek Hudmon, Karen; Medicine, School of MedicineBackground: Although two thirds of tobacco users express interest in quitting, few pharmacists address tobacco use as part of routine practice. Historically, pharmacy schools provided inadequate tobacco cessation training for students. To address this educational gap, train-the-trainer workshops were conducted between 2003 and 2005 to train pharmacy faculty (n = 191) to teach a shared, national tobacco cessation curriculum at their academic institutions. Objective: To characterize faculty perceptions of the train-the-trainer workshops and estimate the long-term reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) of the shared curriculum at pharmacy schools. Methods: This study is the second phase of a sequential mixed methods study. Results from Phase 1, a qualitative study, informed the development of survey items for Phase 2. Applying the RE-AIM framework, a web-based survey was developed and administered to train-the-trainer participants. Results: Of 191 trainees, 137 were locatable; of these, 111 completed a survey (81.0%). Most (n = 87; 78.4%) reported current employment in academia. The most highly rated reason for attending a workshop was to improve teaching of tobacco cessation content, and 98.1% reported moderate or high confidence for teaching tobacco cessation. Among those who practice in a clinical setting, 70.6% reported asking their patients about tobacco use all or almost all the time. Just over three fourths of faculty respondents who work in academia believe that shared curricula should be more broadly considered for use in pharmacy schools, and 79.0% agreed that shared curricula are a cost-effective approach to teaching. Conclusion: Evidence is provided for long-term reach, effectiveness, adoption, implementation, and maintenance of the Rx for Change shared tobacco cessation training program. Participants perceived that the workshop resulted in long-term, positive effects on their careers as well as their teaching and clinical practice.Item Pharmacist-Led Implementation of Brief Tobacco Cessation Interventions during Mobile Health Access Events(MDPI, 2023-04-07) Hudmon, Karen Suchanek; Czarnik, Julia S.; Lahey, Alexa M.; Crowe, Susie J.; Conklin, Megan; Corelli, Robin L.; Gonzalvo, Jasmine D.; Ellis Hilts, Katy; Health Policy and Management, School of Public HealthTo address gaps in care for individuals from under-resourced communities disproportionately affected by tobacco use, this pharmacist-led demonstration project evaluated the feasibility of implementing tobacco use screening and brief cessation interventions during mobile health access events. A brief tobacco use survey was administered verbally during events at two food pantries and one homeless shelter in Indiana to assess the interest and potential demand for tobacco cessation assistance. Individuals currently using tobacco were advised to quit, assessed for their readiness to quit, and, if interested, offered a tobacco quitline card. Data were logged prospectively, analyzed using descriptive statistics, and group differences were assessed by site type (pantry versus shelter). Across 11 events (7 at food pantries and 4 at the homeless shelter), 639 individuals were assessed for tobacco use (n = 552 at food pantries; n = 87 at the homeless shelter). Among these, 189 self-reported current use (29.6%); 23.7% at food pantries, and 66.7% at the homeless shelter (p < 0.0001). About half indicated readiness to quit within 2 months; of these, 9 out of 10 accepted a tobacco quitline card. The results suggest that pharmacist-led health events at sites serving populations that are under-resourced afford unique opportunities to interface with and provide brief interventions for people who use tobacco.Item Promoting pharmacy-based referrals to the tobacco quitline: a pilot study of academic detailing administered by pharmacy students(Sage, 2015) Wahl, Kimberly R.; Woolf, Brittany L.; Hoch, Matthew A.; Zillich, Alan J.; Suchanek Hudmon, Karen; Medicine, School of MedicineObjective: To conduct a pilot study of a student-delivered academic detailing initiative to promote brief, pharmacy-based tobacco cessation interventions, and referrals to the tobacco quitline. Methods: Pharmacy students (n = 11) received training and delivered academic detailing sessions for promoting brief tobacco cessation interventions at community pharmacies (n = 37). Six months after the session, a survey was faxed to each pharmacy to assess (1) the quality and acceptance of the academic detailing session and the materials provided during the session and (2) tobacco cessation counseling perceptions and practices. Results: Pharmacists from 30 (81%) sites responded to the survey; of these, 37% reported that they increased the number of patients asked about smoking since the academic detailing session, 70% reported an increase in the number of participants advised to quit smoking, 57% reported an increase in the number of patients counseled, and 50% reported routinely providing referrals to the tobacco quitline. Conclusion: pharmacy students are capable of providing academic detailing for brief tobacco cessation interventions in community pharmacies. Results of this pilot study suggest a positive impact of this service on pharmacists' counseling behavior for tobacco cessation.