Sohanpal Ratna, Rivas Carol, Steed Liz, MacNeill Virginia, Kuan Valerie, Edwards Elizabeth, Griffiths Chris, Eldridge Sandra, Taylor Stephanie, Walton Robert
Asthma UK Centre for Applied Research, Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
Faculty of Health Sciences, University of Southampton, Southampton, UK.
BMJ Open. 2016 Jul 7;6(7):e010921. doi: 10.1136/bmjopen-2015-010921.
To understand views of pharmacy advisers about smoker recruitment and retention in the National Health Service community pharmacy stop smoking programme.
Thematic framework analysis of semistructured, in-depth interviews applying the Theoretical Domains Framework and COM-B behaviour change model. We aimed to identify aspects of adviser behaviour that might be modified to increase numbers joining and completing the programme.
25 stop smoking advisers (13 pharmacists and 12 support staff).
29 community pharmacies in 3 inner east London boroughs.
Advisers had preconceived ideas about smokers likely to join or drop out and made judgements about smokers' readiness to quit. Actively recruiting smokers was accorded low priority due in part to perceived insufficient remuneration to the pharmacy and anticipated challenging interactions with smokers. Suggestions to improve smoker recruitment and retention included developing a more holistic and supportive approach using patient-centred communication. Training counter assistants were seen to be important as was flexibility to extend the programme duration to fit better with smokers' needs.
Cessation advisers feel they lack the interpersonal skills necessary to engage well with smokers and help them to quit. Addressing advisers' behaviours about active engagement and follow-up of clients, together with regular skills training including staff not formally trained as cessation advisers, could potentially boost numbers recruited and retained in the stop smoking programme. Adjustments to the pharmacy remuneration structure to incentivise recruitment and to allow personalisation of the programme for individual smokers should also be considered.
了解药剂师顾问对于国民医疗服务体系社区药房戒烟项目中吸烟者招募及留存情况的看法。
运用理论领域框架和COM-B行为改变模型，对半结构化深度访谈进行主题框架分析。我们旨在确定可能需要改进的顾问行为方面，以增加参与并完成该项目的人数。
25名戒烟顾问（13名药剂师和12名辅助人员）。
伦敦东区3个行政区的29家社区药房。
顾问们对可能加入或退出的吸烟者有先入为主的看法，并对吸烟者的戒烟意愿做出判断。积极招募吸烟者的优先级较低，部分原因是认为药房报酬不足以及预计与吸烟者的互动具有挑战性。改善吸烟者招募和留存的建议包括采用以患者为中心的沟通方式，制定更全面、更具支持性的方法。培训柜台工作人员被认为很重要，灵活延长项目持续时间以更好地满足吸烟者的需求也很重要。
戒烟顾问觉得他们缺乏与吸烟者良好沟通并帮助他们戒烟所需的人际技能。解决顾问在积极接触和跟进客户方面的行为问题，以及定期开展技能培训（包括未接受过正式戒烟顾问培训的工作人员），可能会增加参与戒烟项目的人数并提高留存率。还应考虑调整药房薪酬结构，以激励招募工作，并允许为个体吸烟者量身定制项目。
