CAN-ADAPTTDeveloping a Canadian

smoking cessation guideline

Cameron D. Norman, PhD

& Peter Selby, MBBS CCFP

Canadian Psychological Association Annual Meeting

Winnipeg, MB June 3, 2010

Outline

What is CAN-ADAPTT? What makes CAN-ADAPTT unique?

1. Dynamic guideline

2. Adapted Wiki platform

3. Discussion Board

4. PBRN How to get involved

What is CAN-ADAPTT?

Canadian Action Network for the Advancement, Dissemination and Adoption

of Practice-informed Tobacco Treatment

Informing the development of Canada’s first national guideline for smoking cessation

Vision

National access to an evidence- informed practice guideline

 

A Canada where health care providers have access to the tools needed to deliver up to date evidence-based smoking cessation interventions to reduce the prevalence of tobacco use and dependence.

Goal

Building bridges between research and practice

  To establish a national practice-based research network

to facilitate knowledge exchange to inform the development of a dynamic cessation guideline for use in clinical practice and population-based strategies within Canada.

Rationale

“There are therefore 2 major disconnects between research and practice: research may not translate expeditiously to everyday practice, and clinical problems encountered in everyday practice are often under-investigated.” (Tierney et al., 2007)

Rationale

This project aims to address this gap by:

1. Developing a dynamic guideline;• New evidence can be incorporated as it becomes

available

2. Encouraging practice-based research; • Seed grants• Practice-informed research agenda

National Network• Practitioners• Researchers• Policy-makers

Practice-informedResearch Agenda • Seed grants• Discussion board• AGM

Dissemination & Engagement• Stakeholders• Professional

Advisory Groups

Knowledge Translation

• Seed grants• Discussion board

PRACTICERESEARCH

Existing Guidelines

Healthcare providers/practitioners have indicated a number of reasons as to why they have not completely embraced the guidelines:

don’t reflect local or current circumstances

are quickly out of date

reflect large gaps between the perspectives of experts and the day-to-day experiences of practitioners

1. Dynamic Guidelines

The guideline is termed “dynamic” in order to reflect a continuously evolving evidence base, practice environment, client needs and treatment opportunities.

Traditional Guideline Process

Arbitrarily scheduled review date (often every 5-10 years)

Wasted resources if full update done in a slowly evolving field

Guideline quickly out of date in rapidly evolving field Costly to assemble GDG for revision and to

disseminate guidelines

Dynamic Guidelines

Guideline is updated as new evidence becomes available – continuous & prospective

Outdated recommendations can easily and quickly be removed or modified

Timely & readily useable to those in a position to help smokers

Cost efficient, easy access to guidelines

Wiki Platform

A wiki is a collaborative website which can be directly edited by anyone with access to it.

Wiki Platform

Provides a mechanism to support collaboration and knowledge translation with geographically dispersed groups

Permit rapid updating of content to ensure relevancy and timeliness of the materials

2. Wiki CPGs

A collaborative model approach involves health care/service providers, researchers and other smoking cessation stakeholders vs. closed, centralized process of traditional CPG development

Wiki CPG can be updated as new knowledge is produced

3. Online Discussion Board

Facilitates research & knowledge exchange Comment on existing guidelines, identify gaps in research Propose research questions based on

front-line practice Ask questions, receive feedback from

other practitioners and researchers Share resources, new research,

disseminate findings from seed grants Network & initiate research collaborations

4. Practice Based Research Network

Primary care research seeks to answer questions of immediate relevance to the health of the community

CAN-ADAPTT aims to build bridges between research and practice

Currently over 500 network members to date

How to get involved…

1.

2.

3.

Achievements

Over 500 network members Members of 20 national professional

organizations make up Professional Advisory Group

22 seed grant applications submitted and 12 grants awarded

2 Annual General Meetings held • Next guideline revision meeting to be held in October

2010 re: population level approaches Version 2.0 of guideline launching soon

Involvement of Psychologists

Currently, CAN-ADAPTT has limited representation from psychologists within the network

CAN-ADAPTT seeks your perspective on effective therapies.

Revised psychosocial and counseling summary statements will be released shortly, for external review• A great time to provide feedback prior to the

release

Benefits of Joining

Access the up-to-date clinical practice guideline Opportunities to contribute to the development

of Canada’s first national, dynamic CPG Links to a variety of resources including

websites, projects, literature reviews and articles Updates on meetings/conferences A discussion board to connect with colleagues,

share resources and comment on the guideline

Counselling and Psychosocial Summary Statements

Treatment delivered by a variety of health care providers is effective at increasing rate of abstinence.

Multiple sessions of counselling increase the chances of a successful quit.

Counselling in a variety and combination of formats, including telephone, group and individual counselling, are effective and should be used to assist patients willing to quit.

Please note: these summary statements are currently under internal review and will be launch on the website shortly

Counseling and Psychosocial Summary Statements

Motivational interviewing techniques should be used to support a patient’s willingness to quit now and in the future.

Behavioural and cognitive therapy has been validated and is recommended for intensive smoking cessation interventions.

Follow up visits should be conducted regularly to assess abstinence and challenges associated with quitting.

For more information

CAN-ADAPTT

Centre for Addiction and Mental Health

T: 416-535-8501 ext. 7427

E: can_adaptt@camh.net

www.can-adaptt.net

Questions