Hospitalized Smokers
Conditions
Brief summary
Post-discharge support is a key component of effective treatment for hospitalized smokers, but very few hospitals provide it. Linking hospitalized smokers with free, proactive tobacco quitlines is an ideal way to provide supportive contact at discharge, because quitlines are effective and cost effective for smoking cessation. Many hospitals are beginning to fax-refer smokers to quitlines at discharge. Fax referral is convenient and is part of the current culture of medical communication channels. However, less than half of fax-referred smokers are successfully contacted and enrolled in quitline services. Warm hand-off is a novel approach to care transitions in which health care providers directly link patients that have substance abuse and mental health problems with specialists, using face-to-face or phone transfer. Warm hand-off achieves very high rates of treatment enrollment for these highly vulnerable groups.
Detailed description
The objective if this application is to determine the relative effectiveness, and cost-effectiveness, of warm hand-off versus fax referral for linking hospitalized smokers with tobacco quitlines. This study employs a two-arm, individually randomized design. It is set in two large Kansas hospitals that have dedicated tobacco treatment interventionists on staff.
Interventions
OTHERWarm Hand-off
Warm Hand-Off Staff brief intervention and warm hand-off (5 min): * Assess withdrawal, need for medication change * Describe warm hand-off process * Provide 2-page flyer * Perform call, leave room * Notify patients' nurse patient is talking to quitline Quitline session (20 min): * Collect minimum data set * Explore thoughts/feelings toward quitting * Provide medication education * Build plan to stay quit * Schedule next call Staff check-back (5 min): * Ask patient how session went * Ask if patient requests cessation medication script on discharge
OTHERFax
Fax Staff standard in-patient session: (30 minutes): * Assess withdrawal, need for medication change * Conduct assessment of smoking history, interest in quitting * Explore relevance, risks, rewards, and roadblocks (4Rs) related to smoking and quitting * Provide 2-page flyer * Provide medication education * Build plan to stay quit * Describe fax-referral process * Ask if patient requests cessation medication script on discharge
Sponsors
University of Kansas Medical Center
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Inclusion criteria include being residents of Kansas, * aged 18 years and older, * have smoked at least 1 cigarette in the 30 days prior to admission, * speak Spanish or English, * and wish to remain abstinent after they are discharged * Patients who are discharged to another facility (for long term care or rehabilitation) will be included in the trial.
Exclusion criteria
*
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| 7-day point-prevalence, verified smoking cessation | up to 6 months | To test the effects of warm hand-off versus fax referral on smoking cessation |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Enrollment in quitline services and adherence to quitline counseling sessions | up to 6 months | To test the effects of warm hand-off versus fax referral on enrollment and adherence in quitline services |
| To examine the costs to providers and participants of the intervention and control conditions | up to 6 months | To examine the cost-effectiveness of the intervention |
Countries
United States
Outcome results
None listed