1. Smoking: We ask about it, but do we act on it
Smoking: We ask about it, but do we act on it? Measuring the impact of brief advice on smoking cessation. Lorraine Ogbonmwan Senior Physiotherapist, Fairfield General Hospital
The smoking prevalence of people in Bury is 19.1% compared with the England average of 15.5%. There is a high incidence of smoking in more socially deprived areas .The rate of smoking related deaths in Bury is 337 (per 100,000 population) worse than the average for England at 284. This represents approximately 332 deaths per year. Smoking costs the NHS approximately £2 billion per year for treating diseases caused by smoking. The Physiotherapy department at Fairfield General Hospital implements a ‘Making Every Contact Count’ (MECC) approach into its service pathway. The Public Health England logic models have been adopted to measure impact of engaging in healthy conversations. Some staff reported not feeling comfortable in asking patients about their smoking status and those that did were not confident in giving brief advice to patients regarding stopping smoking.
1. INTRODUCTION
2. AIMS
5. RESULTS
Use principles of MECC to raise issues of smoking and establish smoking status (including E-cigarette use).
Offer very brief advice on smoking cessation to patients as necessary.
Signpost patients to smoking cessation services.
No. of people asked: (409).
Non smokers: (281) 69%.
Ex smokers: (76) 18%.
Smokers including E-cig use: (52) 13%.
Brief advice given: (37) out of 128 Ex and current smokers.
% of people signposted: 29%.
No. of referrals from Physiotherapy received by local smoking cessation service: (4).
Uptake of referrals within community services: (2 out of 4) 50%.
3. METHOD
Very brief advice e-learning delivered to Physiotherapy staff on smoking cessation to increase confidence to ask the right questions.
Health and wellbeing assessment tool used during Physiotherapy assessments to facilitate healthy conversations within the outpatient department at Fairfield General Hospital between June and November 2017 to determine smoking status of patients and any previous quit attempts.
Patients who are current smokers are offered brief advice (along with ex smokers) and signposted to smoking cessation services within the local community in Bury (Bury Lifestyle Team) and referred to online support services such as ‘SmokeFree’, ‘One You’ and to local Pharmacies.
Local smoking cessation service provide numbers of smoking cessation referrals received from Physiotherapy along with the uptake of referrals.
6. DISCUSSION
The results show that engaging in healthy conversations and offering brief advice along with signposting patients has had a positive impact on influencing smokers to make a quit attempt. This supports implementation of the CQUIN: Preventing ill health. Future recommendations include: evaluation of Physiotherapy staffs knowledge and skills in delivering brief advice, tailored workforce development, liaising with the local Public Health Lead to provide feedback, and developing a mechanism to monitor uptake of referrals from other smoking cessation services .
4. LIMITATIONS
It was reported that the Health assessment tool was not always used during assessments by staff due to time constraints.
It was difficult to estimate the true uptake of brief advice given due to lack of information from online support services.
7. REFERENCES