Optimizing the Implementation of Tobacco Treatment for People with HIV: A Pilot Study

People with HIV (PWH) have higher rates of tobacco use compared to their societal counterparts and are disproportionately affected by tobacco-related morbidity and mortality. A needs assessment was conducted to assess provider beliefs and opinions on tobacco treatment barriers and treatment approach...

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Bibliographic Details
Published in:International journal of environmental research and public health 2022-10, Vol.19 (19), p.12896
Main Authors: Foster, Madeline G, Toll, Benjamin A, Ware, Emily, Eckard, Allison Ross, Sterba, Katherine R, Rojewski, Alana M
Format: Article
Language:English
Subjects:
Cancer therapies
Cigarette smoking
Confidence
Counseling
Drug addiction
Drug therapy
HIV Infections - drug therapy
Humans
Lung cancer
Morbidity
Mortality
Nicotinic Agonists - therapeutic use
Patients
Pharmacists
Pharmacology
Pilot Projects
Smoking
Smoking cessation
Smoking Cessation - methods
Tobacco
Tobacco Products
Tobacco Use
Tobacco Use Cessation Devices
Varenicline - therapeutic use
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Summary:People with HIV (PWH) have higher rates of tobacco use compared to their societal counterparts and are disproportionately affected by tobacco-related morbidity and mortality. A needs assessment was conducted to assess provider beliefs and opinions on tobacco treatment barriers and treatment approaches. The results highlighted a disconnect between the known importance of quitting smoking and barriers in linking patients to treatment, such as lack of patient interest and other patient issues being a higher priority. Using this assessment data, a treatment delivery approach, Proactive Outreach with Medication Opt-out for Tobacco Treatment Engagement (PrOMOTE), was devised and piloted. PrOMOTE consisted of an outpatient clinical pharmacist trained in tobacco treatment proactively contacting patients for counseling and to prescribe smoking cessation pharmacotherapy (varenicline or dual nicotine replacement therapy (NRT)) using an opt-out approach. The pilot was conducted with 10 PWH and patient reach and opt-out rates were evaluated. Of the 10 patients contacted, 7 were reached and none opted out of the pharmacotherapy prescription (varenicline = 6; NRT = 1). Providers know the importance of smoking cessation for PWH but encounter several barriers to implementing treatment. Using PrOMOTE methods to deliver tobacco treatment increased the reach and pharmacotherapy acceptance rate of PWH who smoke.
ISSN:1660-4601
1661-7827
1660-4601
DOI:10.3390/ijerph191912896