Open AccessImplementation of a Comprehensive Hospital-Based Smoking-Cessation Program in Cancer
Author(s) -
Nazek Abdelmutti,
Janette Brual,
Jennifer Jones,
David P. Goldstein,
G. Liu,
Lawson Eng,
Janet Papadakos,
Tina Papadakos,
Meredith Giuliani
Publication year - 2018
Publication title -
journal of global oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.002
H-Index - 17
ISSN - 2378-9506
DOI - 10.1200/jgo.18.98400
Subject(s) - smoking cessation , medicine , referral , family medicine , context (archaeology) , ehealth , nursing , health care , paleontology , pathology , biology , economics , economic growth
Background and context: Quitting smoking after a cancer diagnosis minimizes treatment-related effects, improves prognosis and enhances quality of life. However, smoking cessation has yet to be integrated as a standard component of cancer care and cessation programs are underused. Aim: To address this gap between evidence and practice, the Princess Margaret Cancer Centre in Toronto, Canada sought to implement a comprehensive, evidence-based program that would introduce smoking cessation–related screening, referrals and education as standard practice in cancer care. Strategy/Tactics: We adapted the Framework for Managing eHealth Change to guide successful implementation of a Smoking Cessation Program (SCP) utilizing 6 components: 1) Leadership and governance 2) Stakeholder engagement and partnerships 3) Communication 4) Patient and provider education 5) Analysis and clinical integration 6) Monitoring and evaluation of program performance metrics. Program/Policy process: The SCP designed, tested and implemented a multilingual e-referral system (CEASE) to screen patients for smoking status, provide education and advice on quitting, and generate an electronic referral to cessation programs. Partnerships were established with 3 smoking-cessation programs to offer patients a breadth of services tailored to individual needs, preferences and medical history. Patient and provider education was developed to address the unique knowledge gaps, beliefs and stigma associated with smoking and a cancer diagnosis. Outcomes: Program metrics indicate that of 11,366 new patients eligible for screening between April 2017 to March 2018, 62% (n = 6629) were screened with 10% (n = 655) identifying as current smokers and 4% (n = 261) as recent quitters (6 months or less). Of smokers and recent quitters, 21% (n = 170) accepted a referral to a smoking-cessation program. What was learned: The implementation of the SCP presents a comprehensive blueprint to establish a smoking-cessation program as a standard of quality care. Elements of the SCP can be adapted to local, regional and national contexts. Future directions include assessing strategies to increase screening and referral rates, collection of long-term outcomes, and integration into the patient portal.