Training health professionals in smoking cessation

 

Abstract

Background

There is good evidence that brief interventions from health professionals can increase rates of smoking cessation. A number of trials have examined whether specific skills training for health professionals leads them to have greater success in helping their patients who smoke.

Objectives

The aim of this review was to assess the effectiveness of training health care professionals to deliver smoking cessation interventions to their patients, and to assess the additional effects of prompts and reminders to the health professional to intervene.

Search methods

We searched the Cochrane Tobacco Addiction Group trials register for studies relating to training.

Selection criteria

Randomised trials in which the intervention was training of health care professionals in smoking cessation. Trials were considered if they reported outcomes for patient smoking rates at least six months after the intervention. We reported on process outcomes, but we excluded trials that reported effects only on process outcomes and not smoking behaviour.

Data collection and analysis

We extracted data in duplicate on the type of health professionals, the nature of and duration of the training, the outcome measures, method of randomisation, and completeness of follow-up.

The main outcome measures were 1. Rates of abstinence from smoking after at least six months follow-up in patients smoking at baseline. 2. Rates of performance of tasks of smoking cessation by health care professionals including offering counselling, setting quit dates, giving follow-up appointments, distributing self-help materials and recommending nicotine gum.

Main results

Healthcare professionals who had received training were more likely to perform tasks of smoking cessation than untrained controls. Of eight studies that compared patient smoking behaviour between trained professionals and controls, six found no effect of intervention. The effects of training on process outcomes increased if prompts and reminders were used.

Authors' conclusions

Training health professionals to provide smoking cessation interventions had a measurable effect on professional performance. There was no strong evidence that it changed smoking behaviour.

 

Plain language summary

Can quit rates be improved by training health professionals to ask people if they smoke and to offer them advice

Training programs are used to encourage health professionals to ask people if they smoke, and then offer advice to help them quit. The review of trials found that these programs increase the number of people health professionals identify as smokers. The programs also increase the number of people offered advice and support for quitting by health professionals. However, there is not strong evidence that this results in more people quitting smoking.

 

摘要

背景

健康專業人員戒菸訓練

已經有很好的證據證實：由健康照護人員提供簡短的戒菸介入，能增加戒菸率。已經有一些研究探討是否針訓練健康照護人員使用某些特定技巧，有較高的成功率讓吸菸病人戒菸。

目標

本文目的是評估訓練健康照護人員對病人進行戒菸介入的效果，同時評估增加和提醒健康專業人員介入的額外效果。

搜尋策略

我們搜尋 Cochrane Tobacco Addiction Group trials register中有關於訓練的研究。

選擇標準

培訓醫護人員如何進行戒菸介入的隨機試驗。納入的標準為有介入後至少6個月後的戒菸率。我們有正在戒菸人數的數據，但排除只有正在戒菸人數而沒有吸煙者行為。

資料收集與分析

我們摘錄資料一式兩份，包括醫護專業人員的型態、訓練的本質及時間、結果測量、隨機分派的方法、追蹤期間的完整度。主要的結果指標是 1.基期吸菸患者，追蹤至少6個月後的戒煙率。2.醫護專業人員要患者戒菸的頻率，包括提供諮詢，設定戒菸日期，後續追蹤，分配自助材料和推薦尼古丁口香糖

主要結論

比起沒有接受訓練的醫護專業人員，接受了訓練的專業人員更可能協助患者戒菸。8個試驗比較受過培訓的專業人員和控制組，兩組病人的吸菸行為。其中六個研究沒有發現治療效果。如果有提示和提醒，那麼訓練對正在戒菸人數的影響效果會增加。

作者結論

訓練健康專業人士提供戒菸介入對促進他們的專業表現有顯著成果。但是並沒有強有力的證據證明訓練專業人士提供戒菸服務能改變病人吸菸的行為。

翻譯人

本摘要由成功大學附設醫院尹子真翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

沒有足夠的證據表明，藉由訓練衛生專業人員詢問市民是否吸菸，並為他們提供諮詢的戒菸訓練能改善戒菸率。訓練計畫的目的是鼓勵衛生專業人員詢問市民是否吸菸，並提供意見，以幫助他們戒菸。回顧發現，這些計畫能增加健康專業人員發現吸菸病人的數量。同樣也增加了得到戒菸資訊和協助的人數。然而，沒有強而有力的證據證明這麼做能導致更多的人戒菸。