Subject(s)
Mycobacterium Infections, Nontuberculous/diagnosis , Mycobacterium abscessus , Skin Diseases, Bacterial/diagnosis , Adolescent , Face , Female , Humans , Mycobacterium Infections, Nontuberculous/etiology , Mycobacterium Infections, Nontuberculous/therapy , Skin Diseases, Bacterial/etiology , Skin Diseases, Bacterial/therapyABSTRACT
BACKGROUND: Clinical practice guidelines recommend that all medical providers address tobacco use with patients, as the long-term health benefits of becoming tobacco free are well documented. What happens, though, when a patient has an incurable malignancy and, therefore, will not reap the long-term benefits? Clinical Consideration: Our case study encourages providers to consider the relevance of tobacco use treatment for those with incurable diseases. DISCUSSION: Although long-term benefits will not provide realistic motivation, other equally important rewards (e.g., decreased shortness of breath), a sense of accomplishment shared by patients and family, and the ability to exert control over a behavior can be equally motivating for some patients.
Subject(s)
Communication , Motivation , Neoplasms/psychology , Quality of Life/psychology , Smoking Cessation/psychology , Terminal Care/psychology , Tobacco Use/psychology , Female , Humans , Male , Middle Aged , North CarolinaABSTRACT
BACKGROUND: Hospitalization offers an optimal environment for ensuring that patients receive evidence-based treatment. An inpatient tobacco treatment program can deliver interventions broadly, but minimal research has examined the impacts of a consult program on inpatient providers. The Nicotine Dependence Program at the University of North Carolina has provided an inpatient tobacco treatment consult service since 2010. OBJECTIVE: The program sought feedback from inpatient providers to examine factors that prompted tobacco treatment consult orders, the impact on provider counseling behavior, provider satisfaction, and suggested program improvements. DESIGN: Providers who had ordered a tobacco treatment consult received an online anonymous survey. SETTING: The University of North Carolina Hospital is an academic medical facility with 803 beds and over 37,000 inpatient admissions annually from all 100 counties in North Carolina. Approximately 20% of these inpatients report current use of any tobacco product. PATIENTS/PARTICIPANTS: Medical providers who ordered inpatient tobacco treatment consults from July 2012 to June 2013 (n=265) received the survey, with 118 providers responding (44.5% response rate). RESULTS: Almost all providers reported being satisfied with the consult program and believed it was effective. Key factors in provider satisfaction included ease of accessing the service, saving provider time, and offering patients evidence-based tobacco use treatment. The consult program increased the likelihood of providers prescribing tobacco cessation medications at discharge, as well as following up at post-discharge appointments. CONCLUSION: This is some of the first research to show provider satisfaction, program usage, and outcomes with an inpatient tobacco treatment program and demonstrates the important impact of implementing tobacco treatment services within hospitals.
