Facilitating smoking cessation in patients who smoke: a large-scale cross-sectional comparison of fourteen groups of healthcare providers

E. Meijer; R. M. J. J. Van der Kleij; N. H. Chavannes

doi:10.1186/s12913-019-4527-x

journal article Open Access Oct 25, 2019

Facilitating smoking cessation in patients who smoke: a large-scale cross-sectional comparison of fourteen groups of healthcare providers

E. Meijer R. M. J. J. Van der Kleij N. H. Chavannes

BMC Health Services Research Vol. 19 No. 1 · Springer Science and Business Media LLC

View at Publisher Save 10.1186/s12913-019-4527-x

Abstract

Abstract

Background
Although healthcare providers are well placed to help smokers quit, implementation of smoking cessation care is still suboptimal. The Ask-Advise-Refer tasks are important aspects of smoking cessation care. We examined to which extent a large and diverse sample of healthcare providers expressed the intention to implement smoking cessation care and which barriers they encountered. We moreover examined to which extent the Ask-Advise-Refer tasks were implemented as intended, and which determinants (in interaction) influenced intentions and the implementation of Ask-Advise-Refer.

Methods
Cross-sectional survey among addiction specialists, anaesthesiologists, cardiologists, general practitioners, internists, neurologists, paediatricians, pulmonologists, ophthalmologists, surgeons, youth specialists, dental hygienists, dentists, and midwives (N = 883). Data were analysed using multivariate linear and logistic regression analyses and regression tree analyses.

Results
The Ask-Advice-Refer tasks were best implemented among general practitioners, pulmonologists, midwives, and addiction specialists. Overall we found a large discrepancy between asking patients about smoking status and advising smokers to quit. Participants mentioned lack of time, lack of training, lack of motivation to quit in patients, and smoking being a sensitive subject as barriers to smoking cessation care. Regression analyses showed that the most important determinants of intentions and implementation of Ask-Advise-Refer were profession, role identity, skills, guideline familiarity and collaboration agreements for smoking cessation care with primary care. Determinants interacted in explaining outcomes.

Conclusions
There is much to be gained in smoking cessation care, given that implementation of Ask-Advise-Refer is still relatively low. In order to improve smoking cessation care, changes are needed at the level of the healthcare provider (i.e., facilitate role identity and skills) and the organization (i.e., facilitate collaboration agreements and guideline familiarity). Change efforts should be directed towards the specific barriers encountered by healthcare providers, the contexts that they work in, and the patients that they work with.

Topics

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References

Details

Published: Oct 25, 2019
Vol/Issue: 19(1)
License: View

Authors

E

E. Meijer

R

R. M. J. J. Van der Kleij

N

N. H. Chavannes

Funding

Nederlands Tijdschrift voor Geneeskunde Award: not applicable

Cite This Article

E. Meijer, R. M. J. J. Van der Kleij, N. H. Chavannes (2019). Facilitating smoking cessation in patients who smoke: a large-scale cross-sectional comparison of fourteen groups of healthcare providers. BMC Health Services Research, 19(1). https://doi.org/10.1186/s12913-019-4527-x

Facilitating smoking cessation in patients who smoke: a large-scale cross-sectional comparison of fourteen groups of healthcare providers

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