S4 Diagnosing and treating tobacco dependence in hospital inpatients; identifying health professionals needs and how might we address them?. (12th November 2019)

• Record Type: Journal Article
• Authors: Attar-Zadeh, D; Vaghela, A; Vithlani, M; Restrick, LJ
• Is Part Of: Thorax. Volume 74(2019)Supplement 2
• Page Start: A5
• Page End: A6
• Publication Date: 2019-11-12
• Subjects: Chest -- Diseases -- Periodicals; Thorax; Chest -- Diseases; Periodicals; Periodicals; 617.54
• DOI: 10.1136/thorax-2019-BTSabstracts2019.10
• Languages: English
• ISSNs: 0040-6376

Abstract

Abstract : Introduction: Tobacco Dependence (TD) is a long-term condition with evidence-based clinically effective treatment; skilled behaviour change conversations in combination with prescribed medication (nicotine replacement therapy (NRT)/varenicline). Historically diagnosing and treating TD has not been included in health care professional (HCP) training. Objectives: The aim of this study was to assess hospital-based HCPs needs in an inner city Acute Trust in diagnosing/treating TD in inpatients and evaluate whether tailored training can address these needs. Methods: TD diagnosis/treatment training was designed for trainee doctors, pharmacists and the respiratory MDT (including consultants, nurse specialists and physiotherapists) based on national guidance. An annual cycle of 1–2 hour training was delivered by three clinicians trained and experienced in behaviour change (motivational interviewing (MI)) and TD prescribing. HCP training needs and impact of training were evaluated using scaled 0–10 'importance' and 'confidence' questions based on MI principles. Changes following training were evaluated using paired t-tests. Results: 168 HCPs attended one of eight 1–2 hr TD diagnosis/treatment training sessions between Sept 2017 and March 2019. Importance of HCPs being able to diagnose/treat TD HCPs (n=72) across professions identified it as important to: ask patients about smoking mean (range) 8.1/10 (4–10); advise patients how best to stop smoking 8.1/10 (4–10); and that patients in hospital should be prescribed NRT 8.0/10 (4–10). Need to increase HCP confidence in diagnosing/treating TD Before training HCPs confidence in diagnosing TD was mean 7.9/10 (n=101); mean confidence in discussing TD treatment was 5.7/10 (n=116) and mean confidence in prescribing TD medication was 5.1 (n=56). Impact of training in increasing HCP confidence in diagnosing/treating TD Confidence in diagnosing TD, discussing TD treatment and in prescribing TD medication all increased very significantly with 1–2 hours of clinician-led training p<0.0001. See table 1 for full results. Conclusions: This study shows that HCPs want to be able to diagnose and treat tobacco dependence but without training are not confident to do this. One-off training, delivered by clinician-peers, who are experienced and trained in diagnosing and treating tobacco dependence, and in motivational interviewing, is one way to effectively increase HCP confidence in diagnosing, discussing and treating tobacco dependence.