Smoking cessation intervention in Australian general practice: a secondary analysis of a duster randomised controlled trial

Background GPs have limited capacity to routinely provide smoking cessation support. New strategies are needed to reach all smokers within this setting. Aim To evaluate the effect of a pharmacist-coordinated interdisciplinary smoking cessation intervention delivered in Australian general practice. Design and setting Secondary analysis of a duster randomised controlled trial [RCT] conducted in 41 Australian general practices. Method In all, 690 current smokers were included in this study: 373 from intervention clinics (n = 21) and 317 from control clinics (n = 18). A total of 166 current smokers had spirometry confirmed chronic obstructive pulmonary disease (COPD). In the intervention clinics, trained pharmacists provided smoking cessation support plus (hotline referral. Control clinics provided usual care plus Dwaine referral. Those with COPD in the intervention group (n= 84) were referred for home medicines review (HMR) and home-based pulmonary rehabilitation (HomeBasel, which included further smoking cessation support. Outcomes included carbon monoxide (CO)-validated smoking abstinence, self-reported use of smoking cessation aids, and differences between groups in readiness-to-quit score at 6 months. Results Intention-to-treat analysis showed similar CO-validated abstinence rates at 6 months in the intervention 14.0%) and control clinics (3.5%). No differences were observed in readiness to quit scores between groups at 6 months. CO-validated abstinence rates were similar in those who completed HMR and at least six sessions of Home-Base to those with COPD in usual care. Conclusion A pharmacist-coordinated interdisciplinary smoking cessation intervention when integrated in a general practice setting had no advantages over usual care. Further research is needed to evaluate the effect of HMR and home-based pulmonary rehabilitation on smoking abstinence in smokers with COPD.

Automated summary

The study aimed to evaluate the impact of a pharmacist-coordinated interdisciplinary smoking cessation intervention in Australian general practice, showing no advantage over usual care in smoking cessation outcomes. Further research is needed to assess the effect of home medicines review and home-based pulmonary rehabilitation on smoking abstinence in COPD patients.