Assessing the effectiveness of a pharmacist-delivered smoking cessation program in the State of Qatar: study protocol for a randomized controlled trial

Maguy Saffouh El Hajj, Nadir Kheir, Ahmad Mohd Al Mulla, Daoud Al-Badriyeh, Ahmad Al Kaddour, Ziyad R Mahfoud, Mohammad Salehi, Nadia Fanous, Maguy Saffouh El Hajj, Nadir Kheir, Ahmad Mohd Al Mulla, Daoud Al-Badriyeh, Ahmad Al Kaddour, Ziyad R Mahfoud, Mohammad Salehi, Nadia Fanous

Abstract

Background: It had been reported that up to 37% of the adult male population smokes cigarettes in Qatar. The Global Youth Tobacco Survey also stated that 13.4% of male school students aged 13 to 15 years in Qatar smoke cigarettes. Smoking cessation is key to reducing smoking-related diseases and deaths. Healthcare providers are in an ideal position to encourage smoking cessation. Pharmacists are the most accessible healthcare providers and are uniquely situated to initiate behavior change among patients. Many studies have shown that pharmacists can be successful in helping patients quit smoking. Studies demonstrating the effectiveness of pharmacist-delivered smoking cessation programs are lacking in Qatar. This proposal aims to test the effect of a structured smoking cessation program delivered by trained ambulatory pharmacists in Qatar.

Methods/design: A prospective, randomized, controlled trial is conducted at eight ambulatory pharmacies in Qatar. Participants are randomly assigned to receive an at least four-session face-to-face structured patient-specific smoking cessation program conducted by the pharmacist or 5 to 10 min of unstructured brief smoking cessation advice (emulating current practice) given by the pharmacist. Both groups are offered nicotine replacement therapy if feasible. The primary outcome of smoking cessation will be confirmed by an exhaled carbon monoxide test at 12 months. Secondary outcomes constitute quality-of-life adjustment as well as cost analysis of program resources consumed, including per case and patient outcome.

Discussion: If proven to be effective, this smoking cessation program will be considered as a model that Qatar and the region can apply to decrease the smoking burden.

Trial registration: Clinical Trials NCT02123329 .

Figures

Figure 1
Figure 1
Participant flow during the study.

References

    1. Lande G. Nicotine addiction. []
    1. The World Health Organization. The top 10 causes of death Fact sheet []
    1. The World Health Organization: Tobacco []
    1. The World Health Organization. WHO Report on the Global Tobacco Epidemic, 2008 The MPOWER package []
    1. Center for Disease Control and Prevention: Smoking and Tobacco Use Cessation and Interventions []
    1. Roth MT, Andrus MR, Westman EC. Outcomes from an outpatient smoking cessation clinic. Pharmacotherapy. 2005;25(2):279–88. doi: 10.1592/phco.25.2.279.56957.
    1. The World Health Organization: Tobacco Free Initiative []
    1. Canadian Pharmacists Association. Joint Statement on Smoking Cessation- Tobacco the Role of Health Professionals in Smoking Cessation []
    1. Hudmon KS, Prokhorov AV, Corelli RS. Tobacco cessation counseling: pharmacists’ opinions and practices. Patient Educ Couns. 2006;61:152–60. doi: 10.1016/j.pec.2005.03.009.
    1. Aquilino ML, Farris KB, Zillich AJ, Lowe JB. Smoking-cessation services in Iowa community pharmacies. Pharmacotherapy. 2003;23(5):666–73. doi: 10.1592/phco.23.5.666.32192.
    1. Sinclair HK, Bond CM, Stead LF. Community pharmacy personnel interventions for smoking cessation. Cochrane Database Syst Rev. 2004, Issue 1. Art. No.: CD003698. doi: 10.1002/14651858.CD003698.pub2.
    1. Maguire TA, McElnay JC, Drummond A. A randomized controlled trial of a smoking cessation intervention based in community pharmacies. Addiction. 2001;96(2):325–331. doi: 10.1046/j.1360-0443.2001.96232516.x.
    1. Vial RJ, Jones TE, Ruffin RE, Gilbert AL. Smoking cessation program using nicotine patches: linking hospital to the community. J Pharm Pract Res. 2002;32:57–62.
    1. Carroll P, Rois R, Sarson D, Flynn J. A community pharmacy based smoking cessation program using transdermal nicotine replacement therapy: actions and outcomes. Aust Pharmacist. 2000;19:51–5.
    1. Sinclair HK, Bond CM, Lennox AS, Silcock J, Winfield AJ, Donnan PT. Training pharmacists and pharmacy assistants in the stage-of-change model of smoking cessation: a randomized controlled trial in Scotland. Tob Control. 1998;7:253–61. doi: 10.1136/tc.7.3.253.
    1. Zillich AJ, Ryan M, Adams A, Yeager B, Farris K. Effectiveness of a pharmacist-based smoking-cessation program and its impact on quality of life. Pharmacotherapy. 2002;22:759–65. doi: 10.1592/phco.22.9.759.34073.
    1. Dent LA, Harris KJ, Noonan CW. Randomized trial assessing the effectiveness of a pharmacist-delivered program for smoking cessation. Ann Pharmacother. 2009;43(2):194–201.
    1. Smith MD, McGhan WF, Lauger G. Pharmacist counseling and outcomes of smoking cessation. Am Pharm. 1995;NS35(8):20–9.
    1. Kennedy DT, Giles JT, Chang ZG, Small RE, Edwards JH. Results of a smoking cessation clinic in community pharmacy practice. J Am Pharm Assoc (Wash) 2002;42:51–6. doi: 10.1331/108658002763538071.
    1. Dent LA, Scott JG, Lewis E. Pharmacist-managed tobacco cessation program in Veterans Health Administration community-based outpatient clinic. J Am Pharm Assoc (Wash DC) 2004;44:700–15.
    1. Crealey GE, McElnay JC, Maguire TA, O’Neill C. Costs and effects associated with a community pharmacy-based smoking-cessation programme. Pharmacoeconomics. 1998;14(3):323–333. doi: 10.2165/00019053-199814030-00008.
    1. McGhan WF, Smith MD. Pharmacoeconomic analysis of smoking cessation interventions. Am J Health Syst Pharm. 1996;53(1):45–52.
    1. Sinclair HK, Silcock J, Bond CM, Lennox AS, Winfield AJ. The cost-effectiveness of intensive pharmaceutical intervention in assisting people to stop smoking. Int J Pharm Pract. 1999;7:107–12. doi: 10.1111/j.2042-7174.1999.tb00957.x.
    1. Tran MT, Holdford DA, Kennedy DT, Small RE. Modeling the cost-effectiveness of a smoking cessation program in a community pharmacy practice. Pharmacotherapy. 2002;22(2):1623–31. doi: 10.1592/phco.22.17.1623.34118.
    1. FIP Statement of Policy: the Role of the Pharmacist in Promoting a Tobacco Free Future. []
    1. European Forum Pharmacists’ Charter on Action against Smoking []
    1. 2008 PHS Guideline Update Panel, Liaisons, and Staff. Treating tobacco use and dependence: 2008 update U.S. Public Health Service Clinical Practice Guideline executive summary. Respir Care. 2008;53(9):1217–22.
    1. Hudmon KS, Corelli RL. ASHP therapeutic position statement on the cessation of tobacco Use. Am J Health Syst Pharm. 2009;66:291–307. doi: 10.2146/ajhp070303.
    1. Al-Kuwari MG. Tobacco control in Qatar. Middle East J Fam Med. 2008;6(6):11–3.
    1. Al-Mulla A, Bener A. Cigarette smoking habits among Qatari population. Public Health Med. 2003;4(3):41–4.
    1. Global Youth Tobacco Surveillance, 2000-2007 []
    1. Bener A, Zirie M, Kim EJ, Buz R, Zaza M, Nufal, et al. Measuring burden of diseases in a rapidly developing economy: state of Qatar. Glob J Health Sci. 2013;5(2):134–44.
    1. Ibrahim WH, Rasul KI, Khinji A, Ahmed MS, Bener A. Clinical and epidemiological characteristics of lung cancer cases in Qatar. East Mediterr Health J. 2010;16(2):166–70.
    1. Smoking—Addressing a National Epidemic []
    1. El Hajj M, Al-Nakeeb R, Al-Qudah R. Smoking cessation counseling in Qatar: community Pharmacists’ attitudes, role perceptions, and practices. Int J Clin Pharm. 2012;34(4):667–76. doi: 10.1007/s11096-012-9663-x.
    1. Smoking cessation clinic []
    1. Sackey JA. Smoking cessation counseling strategies in primary care. []
    1. Kennedy DT, Small RE. Development and implementation of a smoking cessation clinic in community pharmacy practice. J Am Pharm Assoc. 2002;42(1):83–92. doi: 10.1331/108658002763538116.
    1. Heatherton TF, Kozlowski LT, Frecker RC, Fagerström KO. The Fagerström test for nicotine dependence: a revision of the Fagerström tolerance questionnaire. Br J Addict. 1991;86(9):1119–27. doi: 10.1111/j.1360-0443.1991.tb01879.x.
    1. Al Mohamed HI, Amin TT. Pattern and prevalence of smoking among students at King Faisal University, Al Hassa, Saudi Arabia. EMHJ. 2010;16(1):56–64.
    1. Asfar MD, Vander MW, Maziak W, Hammal F, Eissenberg T, Ward KD. Outcomes and adherence in Syria’s first smoking cessation trial. Am J Health Behav. 2008;32(2):146–56. doi: 10.5993/AJHB.32.2.4.
    1. Olufade AO, Shaw JW, Foster SA, Leischow SJ, Hays RD, Coons SJ. Development of the smoking cessation quality of life questionnaire. Clin Ther. 1999;21(12):2113–30. doi: 10.1016/S0149-2918(00)87242-2.
    1. Smoking Cessation Quality of Life (SCQoL) Questionnaire []
    1. Hudmon KS, Berger BA. Pharmacy applications of the transtheoretical model in smoking cessation. Am J Health Syst Pharm. 1995;52:282–7.
    1. DRUGDEX® Evaluations: Nicotine []
    1. DRUGDEX® Evaluations: Nicotine polacrilex []
    1. Jatlow P, Toll BA, Leary V, Krishnan-Sarin S, O’Malley SS. Comparison of expired carbon monoxide and plasma cotinine as markers of cigarette abstinence. Drug Alcohol Depend. 2008;98(3):203–9. doi: 10.1016/j.drugalcdep.2008.05.013.
    1. Borelli B, Hogan J, Bock B, Pinto B, Roberts M, Marcus B. Predictors of quitting and dropout among women in a clinic-based smoking cessation program. Psychol Addict Behav. 2002;16(1):22–7. doi: 10.1037/0893-164X.16.1.22.
    1. Though the smoke: Tobacco use in the Middle East []
    1. Kheir N, Zaidan M, Younes H, El Hajj M, Wilbur K, Jewesson PJ. Pharmacy education and practice in 13 Middle Eastern countries. Am J Pharm Educ. 2008;72(6):1–13. doi: 10.5688/aj7206133.

Source: PubMed

3
Subscribe