Feasibility and patient satisfaction with smoking cessation interventions for prevention of healthcare-associated infections in inpatients

Danielle M. Schulte, Megan Duster, Simone Warrack, Susan Valentine, Douglas Jorenby, Daniel Shirley, James Sosman, Sheryl L Catz, Nasia Safdar

Research output: Contribution to journalArticle

Abstract

Background: Smoking increases hospitalization and healthcare-associated infection. Our primary aim of this pilot, randomized-controlled trial was to examine the feasibility and acceptability of a tobacco cessation intervention compared with usual care in inpatients. S. aureus carriage, healthcare-associated infections and infections post discharge were exploratory outcomes. Methods: Current inpatient smokers from a university hospital facility were randomized to usual care or a face to face tobacco cessation counseling session where patients' tobacco use and strategies for quitting were discussed. Patient engagement, satisfaction and withdrawal symptoms were measured at 1 week and 12 weeks post discharge. Nasal swabs were collected at enrollment and discharge and assessed for S. aureus colonization. P-values were calculated using Fisher's exact and t-tests were used to compare groups. Results: For the study's primary outcome, participants reported the intervention as being generally acceptable and reported high overall levels of satisfaction, with a Likert scale score of at least 4/5 for all measures of satisfaction. No subjects utilized free tobacco cessation services after discharge. 83 % of the intervention group and 93 % of the control group smoked at least one cigarette after discharge. Secondary outcomes with regard to infections showed that, at discharge, 12 % of the intervention group (n = 17) and 18 % of the control group (n = 22) tested positive for S. aureus. After 3 months, 9 % of the intervention group developed infection, 41 % visited an emergency room, and 24 % were readmitted within 3 months post-discharge, compared to 27, 32 and 36 % of the control group respectively. Conclusions: With regards to the primary aim of this study, there were overall high levels of satisfaction with the intervention, indicating good feasibility and acceptance among patients. However, more intensive interventions in hospitalized patients and impact on healthcare-associated infections and post-discharge infections should be explored.

Original languageEnglish (US)
Article number15
JournalSubstance Abuse: Treatment, Prevention, and Policy
Volume11
Issue number1
DOIs
StatePublished - 2016

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Smoking Cessation
Tobacco Use Cessation
Cross Infection
Patient Satisfaction
Inpatients
Infection
Control Groups
Patient Participation
Substance Withdrawal Syndrome
Tobacco Use
Nose
Tobacco Products
Hospital Emergency Service
Counseling
Hospitalization
Randomized Controlled Trials
Smoking
Outcome Assessment (Health Care)

Keywords

  • Healthcare-associated infections
  • Infection control
  • MRSA
  • Staphylococcus aureus
  • Tobacco cessation

ASJC Scopus subject areas

  • Health Policy
  • Psychiatry and Mental health

Cite this

Feasibility and patient satisfaction with smoking cessation interventions for prevention of healthcare-associated infections in inpatients. / Schulte, Danielle M.; Duster, Megan; Warrack, Simone; Valentine, Susan; Jorenby, Douglas; Shirley, Daniel; Sosman, James; Catz, Sheryl L; Safdar, Nasia.

In: Substance Abuse: Treatment, Prevention, and Policy, Vol. 11, No. 1, 15, 2016.

Research output: Contribution to journalArticle

Schulte, Danielle M. ; Duster, Megan ; Warrack, Simone ; Valentine, Susan ; Jorenby, Douglas ; Shirley, Daniel ; Sosman, James ; Catz, Sheryl L ; Safdar, Nasia. / Feasibility and patient satisfaction with smoking cessation interventions for prevention of healthcare-associated infections in inpatients. In: Substance Abuse: Treatment, Prevention, and Policy. 2016 ; Vol. 11, No. 1.
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abstract = "Background: Smoking increases hospitalization and healthcare-associated infection. Our primary aim of this pilot, randomized-controlled trial was to examine the feasibility and acceptability of a tobacco cessation intervention compared with usual care in inpatients. S. aureus carriage, healthcare-associated infections and infections post discharge were exploratory outcomes. Methods: Current inpatient smokers from a university hospital facility were randomized to usual care or a face to face tobacco cessation counseling session where patients' tobacco use and strategies for quitting were discussed. Patient engagement, satisfaction and withdrawal symptoms were measured at 1 week and 12 weeks post discharge. Nasal swabs were collected at enrollment and discharge and assessed for S. aureus colonization. P-values were calculated using Fisher's exact and t-tests were used to compare groups. Results: For the study's primary outcome, participants reported the intervention as being generally acceptable and reported high overall levels of satisfaction, with a Likert scale score of at least 4/5 for all measures of satisfaction. No subjects utilized free tobacco cessation services after discharge. 83 {\%} of the intervention group and 93 {\%} of the control group smoked at least one cigarette after discharge. Secondary outcomes with regard to infections showed that, at discharge, 12 {\%} of the intervention group (n = 17) and 18 {\%} of the control group (n = 22) tested positive for S. aureus. After 3 months, 9 {\%} of the intervention group developed infection, 41 {\%} visited an emergency room, and 24 {\%} were readmitted within 3 months post-discharge, compared to 27, 32 and 36 {\%} of the control group respectively. Conclusions: With regards to the primary aim of this study, there were overall high levels of satisfaction with the intervention, indicating good feasibility and acceptance among patients. However, more intensive interventions in hospitalized patients and impact on healthcare-associated infections and post-discharge infections should be explored.",
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AU - Schulte, Danielle M.

AU - Duster, Megan

AU - Warrack, Simone

AU - Valentine, Susan

AU - Jorenby, Douglas

AU - Shirley, Daniel

AU - Sosman, James

AU - Catz, Sheryl L

AU - Safdar, Nasia

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N2 - Background: Smoking increases hospitalization and healthcare-associated infection. Our primary aim of this pilot, randomized-controlled trial was to examine the feasibility and acceptability of a tobacco cessation intervention compared with usual care in inpatients. S. aureus carriage, healthcare-associated infections and infections post discharge were exploratory outcomes. Methods: Current inpatient smokers from a university hospital facility were randomized to usual care or a face to face tobacco cessation counseling session where patients' tobacco use and strategies for quitting were discussed. Patient engagement, satisfaction and withdrawal symptoms were measured at 1 week and 12 weeks post discharge. Nasal swabs were collected at enrollment and discharge and assessed for S. aureus colonization. P-values were calculated using Fisher's exact and t-tests were used to compare groups. Results: For the study's primary outcome, participants reported the intervention as being generally acceptable and reported high overall levels of satisfaction, with a Likert scale score of at least 4/5 for all measures of satisfaction. No subjects utilized free tobacco cessation services after discharge. 83 % of the intervention group and 93 % of the control group smoked at least one cigarette after discharge. Secondary outcomes with regard to infections showed that, at discharge, 12 % of the intervention group (n = 17) and 18 % of the control group (n = 22) tested positive for S. aureus. After 3 months, 9 % of the intervention group developed infection, 41 % visited an emergency room, and 24 % were readmitted within 3 months post-discharge, compared to 27, 32 and 36 % of the control group respectively. Conclusions: With regards to the primary aim of this study, there were overall high levels of satisfaction with the intervention, indicating good feasibility and acceptance among patients. However, more intensive interventions in hospitalized patients and impact on healthcare-associated infections and post-discharge infections should be explored.

AB - Background: Smoking increases hospitalization and healthcare-associated infection. Our primary aim of this pilot, randomized-controlled trial was to examine the feasibility and acceptability of a tobacco cessation intervention compared with usual care in inpatients. S. aureus carriage, healthcare-associated infections and infections post discharge were exploratory outcomes. Methods: Current inpatient smokers from a university hospital facility were randomized to usual care or a face to face tobacco cessation counseling session where patients' tobacco use and strategies for quitting were discussed. Patient engagement, satisfaction and withdrawal symptoms were measured at 1 week and 12 weeks post discharge. Nasal swabs were collected at enrollment and discharge and assessed for S. aureus colonization. P-values were calculated using Fisher's exact and t-tests were used to compare groups. Results: For the study's primary outcome, participants reported the intervention as being generally acceptable and reported high overall levels of satisfaction, with a Likert scale score of at least 4/5 for all measures of satisfaction. No subjects utilized free tobacco cessation services after discharge. 83 % of the intervention group and 93 % of the control group smoked at least one cigarette after discharge. Secondary outcomes with regard to infections showed that, at discharge, 12 % of the intervention group (n = 17) and 18 % of the control group (n = 22) tested positive for S. aureus. After 3 months, 9 % of the intervention group developed infection, 41 % visited an emergency room, and 24 % were readmitted within 3 months post-discharge, compared to 27, 32 and 36 % of the control group respectively. Conclusions: With regards to the primary aim of this study, there were overall high levels of satisfaction with the intervention, indicating good feasibility and acceptance among patients. However, more intensive interventions in hospitalized patients and impact on healthcare-associated infections and post-discharge infections should be explored.

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