Focusing on smoking cessation: comparison of two approaches in primary health

careDaniela Florentina Pruteanu Francisco Antón García

Noelia Pastor Gradolí Elena Correcher Salvador Quart de Poblet Health Care Centre

Fuensanta Health Care CentreValencia, Spain

OBJECTIVETo compare the results of two smoking cessation approaches in primary health care: one based on active search of smoker patients and cessation support offer at the practice and the other based on patient referral to a specialised practice performed by a general practitioner (GP).

SUBJECTS AND METHODOLOGY

Our study was developed in two urban health care centres

It included 163 patients, divided in two groups, each one with a different approach of the smoking cessation process. There is one GP who participated in both surgeries.

SUBJECTS AND METHODOLOGY

“Doc, I have a

terrible cough

and fever...

...by the way,

have you ever

thought about

quit smoking?”

In the first approach (A1) the GPs performed an active search of smokers among all the patients that came at the surgery for every reason for consultation and they offered cessation support at their own surgery.

SUBJECTS AND METHODOLOGY

“Doc, the reason I am here today is that I am trying to quit smoking and I don´t know exactly if you could help me with this...”

In the second approach (A2) we included the patients who came seeking for smoking cessation support and they were referred to a specialised practice performed by a GP.

SUBJECTS AND METHODOLOGY

Later on we evaluated the evolution of the smoking cessation process during one year.

In A1 we also determined exhaled carbon monoxide (CM).

Variables Age

Quantification of smoking pack-years

Body mass index (BMI)

Estimated lung age (ELA) using COPD6 Vitalograph (electronic manual device for measuring the lung function)

Drug use for smoking cessation and use of electronic cigarettes (only in A2)

RESULTS A1: N=142 A2: N=21

p = NS p = NS

RESULTSA1/A2: patients that used medicines for smoking cessation: 1/10.

In A2: 1 patient used e-cig, but continued with medicines

p = 0,022 p = 0,026

RESULTS

p = 0,000 p = 0,000

ELA = Estimated Lung Age

RESULTS

P = 0,021; difference 24.1%, 95% CI difference (46%-2.2%) P = 0,000

STUDY LIMITATIONSLow number of patients in A2

CO measuring was available only for the patients in A1 group

There are varibles we couldn´t compare, although data was collected, as spirometry was not available for all the patients included

CONCLUSIONSData regarding age and BMI are similar for both

approaches.

In A2 the mean number of smoking pack years and ELA are higher than in A1.

The smoking cessation percentage in A2 is better, although in A1 (active search) the cessation percentage obtained is high.

These results encourage us to keep on with our work regardless of what approach we may chose.

Thank you for your attention!

Quart de Poblet Health Care CentreFuensanta Health Care Centre

Valencia, Spain