Smoking cessatinn in a community pharmacy: prelminary results of a pharmaceutiical care programme

Background: According to the World Health Organisation, tobacco use is one of the most widespread public health threats in the world, making it particularly urgent to promote smoking cessation. The effectiveness of pharmacist interventions in smoking cessation has been documented in the international literature, but not sufficiently in Portugal. Objective: To report the preliminary results of study to assess the effectiveness of a smoking cessation programme delivered in Portuguese community pharmacies using an outsorcing-based regimen. Methods: Within the scope of a pharmaceutical care programme implemented in seven community pharmacies by an outsourced pharmacist, a specific consultation for smoking cessation was developed, in accordance with Portugal's General Directorate of Health's recommendations and instruments. The smokers were identified and invited to join the programme by the pharmacy staff during their daily activities. Patients that accepted signed an informed consent. Through several face-to-face and phone consultations and based on a comprehensive patient approach, personalised plans to quit tobacco were defined with the patients' agreement. The effectiveness of the service was assessed through the evaluation of quit rates at 1, 6 and 12 months. The continuous variables were expressed as mean ± standard error of the mean. Results: During approximately 5 years (between January 2009 and July 2014), 69 smokers joined the programme. Of these, 17 desisted during the first consultation. Of the remaining 52 patients, the mean age was 47.4 ± 2.11 years old and 55.8% were male. A total of 264 pharmaceutical consultations were delivered and, on average, each patient received 7.7 ± 0.81 interventions. Most interventions (60.1%) were pharmacological (e.g. nicotine replacement products), while non-pharmacological measures (e.g. motivational interviewing) represented 39.9%. Five patients were referred to a physician. At 1 month after the quit date, 37 patients were abstinent (53.6%); 6 months later the number reduced to 24 (34.8%) and, 1 year later, 16 patients remained abstinent (23.2%). Conclusions: The implementation of a smoking cessation programme in community pharmacies using an external pharmacist may contribute effectively to tobacco cessation in Portugal. Antecedentes: Segun la Organizacion Mundial de la Salud, el tabaco es una de las mayores amenazas del mundo, siendo urgente promover el abandono tabaquico. La efectividad de las intervenciones farmaceuticas en cesacion tabaquica ha sido documentada en la literatura, pero no en Portugal. Objetivo: Comunicar los resultados preliminares de un estudio para evaluar la efectividad de un programa de cesacion tabaquica desarrollado en farmacias comunitarias portuguesas usando un regimen de out-sourcing. Metodos: En el ambito de un programa de atencion farmaceutica implantado en siete farmacias por un farmaceutico externalizado, se desarrollo una consulta de cesacion tabaquica siguiendo las recomendaciones e instrumentos de la Direccion General de Salud de Portugal. Se identifico a los fumadores y el personal de la farmacia durante sus actividades rutinarias les invito a unirse al programa. Los que aceptaban firmaban un consentimiento informado. Mediante consultas presenciales y telefonicas y a traves de un abordaje global del paciente, se definieron en acuerdo con el paciente planes personalizados de abandono del tabaquismo. La efectividad del servicio se midio mediante las tasas de cesacion a 1, 6 y 12 meses. Las variables continuas se expresaron como media ± error estandar de la media. Resultados: Durante aproximadamente 5 anos (entre enero 2009 y julio 2014), 69 fumadores se unieron al programa. De estos, 17 desistieron durante la primera consulta. Entre los restantes 52 pacientes, tenian 47.4 ± 2.11 anos y el 55,8% eran hombres. Se realizaron 264 consultas farmaceuticas y, en media cada paciente recibio 7.7 ± 0.81 intervenciones. La mayoria de las intervenciones (60,1%) eran farmacologicas (p.e. productos de substitucion de nicotina), y el restante 39,9% fueron medidas no farmacologicas (p.e. entrevista motivacional). Cinco pacientes fueron remitidos al medico. Despues de 1 mes de la fecha convenida para el inicio de la cesacion, 37 pacientes (53,6%) estaban en abstinencia; 6 meses mas tarde el numero se reducia a 24 (34,8%) y un ano mas tarde 16 pacientes (23,2%) permanecian abstinentes.Conclusion: La implantacion de un programa de casacion tabaquica en farmacias comunitarias, utilizando un farmaceutico externo, puede contribuir efectivamente a la cesacion tabaquica en Portugal.