Mobile health-based approaches for smoking cessation resources.

PURPOSE/OBJECTIVES: To describe how the National Cancer Institute's Cancer Information Service (CIS) smoking-related resources on a mobile health (mHealth) platform were integrated into the workflow of RNs in advanced practice nurse (APN) training and to examine awareness and use of CIS resources and nurses' perceptions of the usefulness of those CIS resources. DESIGN: Descriptive analyses. SETTING: Acute and primary care sites affiliated with the School of Nursing at Columbia University. SAMPLE: 156 RNs enrolled in APN training. METHODS: The integration was comprised of (a) inclusion of CIS information into mHealth decision support system (DSS) plan of care, (b) addition of infobutton in the mHealth DSS, (c) Web-based information portal for smoking cessation accessible via desktop and the mHealth DSS, and (d) information prescriptions for patient referral. MAIN RESEARCH VARIABLES: Use and perceived usefulness of the CIS resources. FINDINGS: 86% of nurses used the mHealth DSS with integrated CIS resources. Of the 145 care plan items chosen, 122 were referrals to CIS resources; infobutton was used 1,571 times. Use of CIS resources by smokers and healthcare providers in the metropolitan area of New York City increased during the study period compared to the prestudy period. More than 60% of nurses perceived CIS resources as useful or somewhat useful. CONCLUSIONS: Integration of CIS resources into an mHealth DSS was seen as useful by most participants. IMPLICATIONS FOR NURSING: Implementation of evidence into workflow using an mHealth DSS can assist nurses in managing smoking cessation in patients and may expand their roles in referring smokers to reliable sources of information. KNOWLEDGE TRANSLATION: mHealth DSS and information prescriptions may support smoking cessation interventions in primary care settings. Smoking cessation interventions can be facilitated through informatics methods and mHealth platforms. Nurses' referrals of patients to smoking-related CIS resources may result in patients' use of the resources and subsequent smoking cessation.

Evidence-based pain guidelines in HIV care.

Despite advances in HIV treatment, pain continues to be a prevalent symptom experienced by persons living with HIV (PLWH) and is associated with sleep disturbance and lower quality of life. Ongoing assessments guide effective pain management. Substance abuse issues and concerns about diversion complicate pain treatment. We reviewed the evidence of current research related to pharmacological and nonpharmacological interventions for pain. A comprehensive review of the literature was conducted, including randomized controlled trials, meta-analyses, evidence-based clinical practice guidelines, and expert opinion; studies of HIV neuropathy and pediatric populations were excluded. We limited the search to English language and human studies. While pharmacology-based interventions are widespread, their efficacy over the long term is questionable. Nonpharmacological therapies are promising and require further study. Aberrant behaviors related to opiates are common in PLWH; expert guidelines to address them are presented. A case study is included to illustrate an application of evidence-based clinical practice.