Pharmacist E‐script transcription service initiated nicotine replacement therapy uptake in pre‐admission clinic: A pilot study

Abstract

AbstractBackgroundPharmacist‐led smoking cessation programs in pre‐admission clinics (PAC) have shown to increase quit attempts and achieve abstinence by the day of surgery (DOS).AimsTo evaluate the feasibility of Pharmacist E‐script Transcription Service (PETS) initiated nicotine replacement therapy (NRT) in PAC, including smoking cessation on DOS.MethodsA single centre, pre and post‐intervention pilot study conducted at an Australian public hospital PAC. In a two‐month intervention period, PAC nursing staff invited smokers (≥1 cigarette/day) to see a smoking cessation PET pharmacist. Pharmacist‐initiated NRT and Quitline© referrals were offered. Cessation outcomes were compared with the preceding two‐month control period. Primary outcome: feasibility of intervention. Secondary outcomes: DOS smoking abstinence rates and three‐months post‐surgery.ResultsPAC nurses identified 112 smokers over 4 months; 53 during pre‐intervention period, and 59 during intervention period. Twenty‐two intervention patients (37%) accepted seeing the pharmacist, with 16 subsequent Quitline© referrals (73%) and 11 NRT prescriptions (50%) written. The median nursing smoking status documentation time increased in the intervention period (1 min vs. 4, p < .001). The intervention did not impact pharmacist's workload. Verified abstinence increased from 8.5% (4/47) pre‐intervention to 9.4% (5/53) post‐intervention, p =1.00. Relapse rates in the intervention period increased (20% vs. 50%) at three‐months post‐surgery.ConclusionA PETS‐initiated NRT program in PAC is feasible and increased preoperative use of NRT and Quitline© with minimal impact on smoking cessation.So what?This study has highlighted the importance of implementing a multidisciplinary smoking cessation program in PAC however, larger studies are needed to determine the true impact of the program on smoking cessations.