Transcript Panhandle Kicks the Habit - Texas Regional Healthcare

Smoking cessation project from Department of Medicine and Pharmacy TTUHSC
Rahul Chandra MD
Assistant Professor
Dept of Medicine ,
TTUHSC Amarillo
Cigarette smoking is injurious to health
everybody knows that !!!!!!!
Its says on the cigarette pack !
Spread the word
……….
Objectives
 Objectives:
 To compare percent of enrolled subjects who achieve abstinence




from smoking at 8 weeks and 6 months compared to Cochrane
database.
To compare percent of subjects who attempt to stop smoking by
enrolling in the study to average percent of other studies.
To compare subjects who use the Facebook page; text messaging
support; smartphone application or combination of these as
offered by the program cessation rate to subjects who do not
utilize the program.
To compare subjects, who do not completely quit smoking,
amount of cigarettes per week at baseline to end of study.
Validate self-reports of abstinence between baseline and 8 weeks
by measuring a level of exhaled carbon monoxide ≤10 ppm.
Inclusion Criteria
 Current Smoker
 Age 18-100
 Admitted to Northwest Texas Hospital under Texas
Tech Internal Medicine service
 Willing to try to quit smoking
 Admitting diagnosis of one of the following:
 Chronic Obstructive Pulmonary Disease, Hypertension,
Asthma, Chronic Heart Failure, Diabetes Mellitus,
History of Coronary Artery Disease or Cerebrovascular
Disease, Pneumonia, or Peripheral Vascular Disease
Exclusion Criteria
 Comatose
 Intubated
 Hospice
 Pregnant
 Breast feeding
 Psychosis
 Does not understand English or Spanish
Precautions for NRT
 Active Unstable angina
 Active MI
 Arrhythmias
 Hyperthyroidism
 Pheochromocytoma
 Accelerated hypertension
 Acute Stroke
 Allergy to nicotine
 Allergy to tape
PANHANDLE KICKS the HABIT
Recruitment
The Northwest smoking cessation educator will identify smokers who are on Texas Tech
Internal Medicine services. She will provide a brochure about the study and explain the
purpose. If a patient is interested she will use a Screener form to ensure that the patient is
a candidate for the study looking at basic inclusion & exclusion criteria.
Inclusion Criteria:





Exclusion Criteria:







Current Smoker
Age 18-100
Admitted to Northwest Texas Hospital under Texas
Tech Internal Medicine service
Willing to try to quit smoking
Admitting diagnosis of one of the following:

Chronic Obstructive Pulmonary Disease,
Hypertension, Asthma, Chronic Heart Failure,
Diabetes Mellitus Type 2, History of Coronary
Artery Disease or Cerebrovascular Disease,
Pneumonia, or Peripheral Vascular Disease
Comatose
Intubated
Hospice
Pregnant
Breast feeding
Psychosis
Does not understand English or
Spanish
Obtain consent for intervention (which means Inpatient counseling,
drug therapy, follow-up counseling and social media/phone
supplement (Facebook, text messages & phone app)
Agree for intervention
Disagree for intervention
Initial Intervention
Continue to enroll subject in study:
1. Fill out Initial Questionnaire
2. FTND Questionnaire
3. Why do you Smoke Questions
4. Baseline Carbon Monoxide Level
IN HOSPITAL INTERVENTION PRIOR TO DISCHARGE
By the Northwest Smoking Cessation Educator
1) Counseling
2) Medications* (patch, gum or combination)
3) Introduce Social media how to access
“Facebook” , text messages, and phone
application.
4) Survival kit( Information card, stress ball,
candy, mints and paper clips)
5) Free 30 day membership to gym may be
offered
1
Follow-up Interventions
Every 2 weeks till a total 8 weeks (60
days) Up to 12 weeks if patient
wants
Intervention at Follow-up
oCarbon Monoxide testing at each
follow-up visit
oGroup Education at least 30 minutes per
session but not more than 60 minutes.
oRefill Medications (patch, gum, or
combination)
oFollow-up kit sunflower seeds, hard
candy, gum and/or toothpicks.
oFollow-up questionnaire (Appendix E)
pertains to questions about
oquitting success
ofeedback on NRT
oactual use of and feedback on Social media
forms of Facebook , text messaging, & phone
app
odocuments any readmission to hospital
Outcomes
Primary outcomes:
Eight weeks of smoking cessation, defined
as self-reported abstinence for 8 weeks
(assessing every 2 weeks) and validated by
measuring a level of exhaled carbon
monoxide of < 10 ppm22.
The percent of subjects who attempt to stop
smoking by enrolling in the study compared to
Cochrane database review of 2008. 23
Secondary outcomes include:
Subjects who use the Facebook page; text
messaging support; phone application or
combination of these as well as their
abstinence rates defined as self-reported at 8
weeks and validated by measuring a level of
carbon monoxide compared to subjects who
did not use these resources.
The percent decrease of cigarettes/week if subject is
still smoking at end of study.
Abstinence rate at 6 months by a telephone call by
subjects self-reporting.
Smartphone application
Text messaging
1. Open Internet Browser
2. Enter: smokefree.gov (see below)
3. Click on SmokefreeTXT (see above)