Background: Smoking counselling during hospitalisation with post-discharge follow-up increases quitting. However, provision of cessation care for hospitalised patients is suboptimal. Students are potentially an untapped resource for providing cessation advice, but no studies have investigated this. Aim: To determine if medical students can encourage motivation to stop smoking (MTSS; primary outcome) in hospitalised smokers . Design: 2-arm RCT Setting: RCSI (www.rcsi.ie) and Connolly Hospital (www.hse.ie/eng/services/list/3/hospitals/Connolly/). Participants: Inpatient smokers. Intervention and procedures: 60 graduate medical students will receive standardised motivational interviewing training in the provision of cessation advice. Each student will be randomly assigned to counsel \~1-3 smokers each, including an individual in-hospital, face-to-face session and post-discharge phone counselling. Training and implementation will cover Sept-2015-May-2016. Smokers will be randomised to 'usual care' (n\~90), or intervention (n\~90, student-delivered motivational interviewing). A researcher will enable recruitment and follow-up, and conduct a qualitative evaluation of programme participants.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
67
The medical student will deliver a brief (approximately 15 minute) consultation with the patient that is based on principles of social cognitive theory and motivational interviewing. The goals of this consultation will be to enhance the patient's motivation and self-efficacy regarding quitting, and collaboratively elicit a plan to stay quit after discharge. Patients will be offered the opportunity to receive a consultation from the attending physician to determine eligibility for pharmacotherapy (via a chart sticker). Each student will counsel 1-3 smokers each over the 8-month academic period, with student training and intervention staggered over this time. Students will also re-contact the smoker at 1-week post-discharge via telephone or personal follow-up, to provide further support.
Connolly Hospital Blanchardstown
Dublin, Ireland
Change in Motivation to Stop Smoking Scale (MTSS)
Repeated measures: MTSS scores at baseline, 1-week, 3- and 6-month follow-up.
Time frame: Repeated measures: MTSS scores at baseline, 1-week, 3- and 6-month follow-up.
Change in motivation to quit
If, on a scale of 1 to 10, 1 is not at all motivated to give up smoking and 10 is 100% motivated to give up, what number would you give yourself at the moment?
Time frame: Repeated measures: single item scores at baseline, 1-week, 3- and 6-month follow-up.
Proportion of patients who receive a prescription for a cessation medication at the time of discharge
The proportion of patients who receive a prescription for a cessation medication at the time of discharge, assessed via medical chart audit;
Time frame: By discharge, an average of 5-10 days post-admission
proportion of patients who report any use of a prescribed or over-the-counter cessation medication
the proportion of patients who report any use of a prescribed or over-the-counter cessation medication, of an approved cessation pharmacotherapy, including nicotine patch, gum, lozenge, inhaler, mouth spray, Champix, or Zyban at 1- and 6-months discharge
Time frame: at 3- and 6-months discharge
proportion of attending physicians who prescribe cessation medication during the hospitalisation
the proportion of attending physicians who prescribe cessation medication during the hospitalisation (to be obtained by medical chart audit);
Time frame: During hospitalisation (baseline)
7-day point prevalent abstinence rates
7-day point prevalent abstinence rates assessed at both 3- and 6-months by self-report
Time frame: 3- and 6-months
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