Real world evaluation of three models of NHS smoking cessation service in England

Original article by: T Mardle, S Merrett, J Wright, F Percival, I Lockhart

Reference: BMC Research Notes 6 Jan 2012;5:9

Source: BMC Research Notes

Keywords: Amfebutamone; Doctors-General Practice; England; Nicotine; Patient Counselling; Pharmacists-Community; Pharmacy Services-Community; Primary Care Trusts; Smoking Cessation; United Kingdom; Varenicline;

Date published: 24/01/2012 08:07

Summary
by: Pharm-line

Background: NHS Stop Smoking Services provide various options for support and counselling.  Most services have evolved to suit local needs without any retrospective evaluation of their efficiency.  Three local service evaluations were carried out at Bournemouth and Poole Teaching Primary Care Trust (PCT) (PCT1), NHS South East Essex (PCT2) and NHS Warwickshire (PCT3) to describe the structure and outcomes associated with different services.

Results: Standardised interviews with key personnel in addition to analysis of data from 400 clients accessing the service after 1 Apr 2008 in each PCT.  The PCTs varied in geography, population size and quit rate (47%-63%).  Services were delivered by PCT-led specialist teams (PCT1), community-based healthcare providers (PCT3) and a combination of the two (PCT2) with varying resources and interventions in each.  Group support resulted in the highest quit rates (64.3% for closed groups vs 42.6% for one-to-one support (PCT1)).  Quit rates were higher for PCT (75.0%) vs GP (62.0%) and pharmacist-delivered care (41.0%) where all existed in the same model (PCT2).  The most-prescribed therapy was NRT (55.8%-65.0%), followed by varenicline (24.5%-34.3%), counselling alone (6.0%-7.8%) and bupropion (2.0%-4.0%).

Conclusions: The results suggest that service structure, method of support, healthcare professional involved and pharmacotherapy all play a role in a successful quit.  Services must be tailored to support individual needs with patient choice and access to varied services being key factors.

The study was funded by Pfizer and one of the authors is a Pfizer employee.

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