de Frel Daan L, Janssen Veronica R, Meijer Eline, Atsma Douwe E
Department of Cardiology, Leiden University Medical Center, Leiden, Netherlands.
National eHealth Living Lab, Leiden University Medical Center, Leiden, Netherlands.
Front Health Serv. 2022 Jul 8;2:882964. doi: 10.3389/frhs.2022.882964. eCollection 2022.
Healthcare professionals (HPs) can play a substantial role in smoking cessation counseling (SCC) but in practice often skip this task due to time constraints. This study evaluates the implementation of the rapid Ask-Advise-Connect (AAC) method in a University hospital setting.
This mixed methods pre-post interventional study was performed at the Cardiology department of a University hospital and consisted of (1) a quantitative assessment of patient smoking registration and HP connection rates to external SCC from the Electronic Medical Record, (2) semi-structured interviews with 10 HPs to assess their attitudes toward AAC, and (3) a blended intervention aimed to implement AAC. The blended intervention consisted of face-to-face and online AAC psychoeducation for HPs followed-up with motivational messages on their smart pagers over a period of 6 weeks.
In total, 48,321 patient registrations and 67 HPs were included. Before AAC implementation, HPs assessed smoking status in 74.0% of patients and connected 9.3% of identified smokers with SCC. Post intervention, these percentages did not increase (73.2%, = 0.20; and 10.9%, = 0.18, respectively). Nonetheless, the vast majority (90%) of HPs feel it is important to discuss patient smoking, and view it as their duty to do so. Main barriers to AAC reported by HPs were forgetfulness and time pressure.
This study shows that this AAC intervention does not increase Asking after smoking status or Connection of patients to SCC in a University Hospital. However, HPs hold positive attitudes toward AAC. A better understanding of the mechanisms required for optimizing HPs practice behavior is needed.
医疗保健专业人员（HPs）在戒烟咨询（SCC）中可发挥重要作用，但在实际工作中，由于时间限制，他们常常跳过这项任务。本研究评估了快速询问-建议-转介（AAC）方法在大学医院环境中的实施情况。
这项混合方法的干预前后研究在一所大学医院的心脏病科进行，包括：（1）从电子病历中对患者吸烟登记情况和医疗保健专业人员与外部戒烟咨询的转介率进行定量评估；（2）对10名医疗保健专业人员进行半结构化访谈，以评估他们对AAC的态度；（3）一项旨在实施AAC的综合干预措施。综合干预措施包括对医疗保健专业人员进行面对面和在线的AAC心理教育，并在6周内通过智能传呼机向他们发送激励信息。
总共纳入了48321例患者登记信息和67名医疗保健专业人员。在实施AAC之前，医疗保健专业人员评估了74.0%的患者的吸烟状况，并将9.3%的已识别吸烟者转介至戒烟咨询。干预后，这些百分比没有增加（分别为73.2%，P = 0.20；和10.9%，P = 0.18）。尽管如此，绝大多数（90%）的医疗保健专业人员认为讨论患者吸烟情况很重要，并将其视为自己的职责。医疗保健专业人员报告的AAC的主要障碍是健忘和时间压力。
本研究表明，在大学医院中，这种AAC干预措施并没有增加询问患者吸烟状况或转介患者接受戒烟咨询的比例。然而，医疗保健专业人员对AAC持积极态度。需要更好地理解优化医疗保健专业人员实践行为所需的机制。
