Cheadle Medical Practice, Cheadle, UK
The CURE Project Team, Greater Manchester Cancer Alliance, Greater Manchester Strategic Health Authority, Manchester, UK.
BMJ Open Respir Res. 2022 Oct;9(1). doi: 10.1136/bmjresp-2022-001334.
Treating tobacco dependency in patients admitted to hospital is a key priority in the National Health Service long-term plan. This service evaluation assessed the perception, needs and experience of care within an opt-out hospital-based tobacco dependency treatment service (the Conversation, Understand, Replace, Experts and Evidence Base (CURE) team) in North-West England.
A survey was offered to all eligible patients between 1 July 2020 and 30 September 2020. Eligibility criteria were adult patients identified as an active smoker being approached by the CURE team as part of the standard opt-out service model, on a non-covid ward without a high suspicion of COVID-19 infection and able to read and write in English.
106 completed surveys were evaluated. Participants demonstrated high levels of tobacco dependency with an average of 37 years smoking history and 66% describing the onset of cravings within 30 min of hospital admission. The average number quit attempts in the previous 12 months was 1.3 but only 9% had used the most effective National Institute for Health and Care Excellence (NICE) recommended treatments. 100% felt the opt-out service model was appropriate and 96% stated the treatment and support they had received had prompted them to consider a further quit attempt. 82% of participants rated their experience of care as 9/10 or 10/10. Participants wanted a broad range of support post discharge with the most popular option being with their general practitioner. 66% and 65% of participants would have been interested in a vaping kit as stop smoking intervention and support vaping-friendly hospital grounds respectively.
These results suggest this hospital-based, opt-out tobacco dependency treatment service delivers high-quality experience of care and meets the needs of the patients it serves. It also highlights the opportunity to enhance outcomes by providing access to NICE recommended most-effective interventions (varenicline, vaping and combination nicotine replacement therapy) and providing flexible, individualised discharge pathways.
在国民保健制度长期计划中，治疗住院患者的烟草依赖是一项关键优先事项。本服务评估评估了英格兰西北部基于医院的烟草依赖治疗服务（对话、理解、替代、专家和证据基础（CURE）团队）中选择退出服务模式下的护理感知、需求和体验。
2020 年 7 月 1 日至 9 月 30 日期间向所有符合条件的患者提供了一项调查。合格标准为被 CURE 团队作为标准选择退出服务模式的一部分识别为主动吸烟者的成年患者，在非新冠病房中，没有 COVID-19 感染的高度疑似感染，并且能够用英语阅读和书写。
评估了 106 份完成的调查。参与者表现出较高的烟草依赖水平，平均吸烟史为 37 年，66%的人在入院后 30 分钟内出现烟瘾发作。在过去 12 个月内尝试戒烟的平均次数为 1.3 次，但只有 9%的人使用了最有效的国家健康与临床优化研究所（NICE）推荐的治疗方法。100%的人认为选择退出服务模式是合适的，96%的人表示他们接受的治疗和支持促使他们考虑进一步戒烟。82%的参与者将他们的护理体验评为 9/10 或 10/10。参与者希望在出院后获得广泛的支持，最受欢迎的选择是与他们的全科医生一起。66%和 65%的参与者分别对电子烟套件作为戒烟干预措施和支持电子烟友好型医院场地感兴趣。
这些结果表明，这种基于医院的、选择退出的烟草依赖治疗服务提供了高质量的护理体验，满足了所服务患者的需求。它还强调了通过提供 NICE 推荐的最有效干预措施（伐伦克林、电子烟和尼古丁替代疗法联合治疗）以及提供灵活的、个性化的出院途径来提高结果的机会。
