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dc.contributor.authorLiebmann, Edward P.
dc.contributor.authorScheuermann, Taneisha S.
dc.contributor.authorFaseru, Babalola
dc.contributor.authorRichter, Kimber P.
dc.identifier.citationLiebmann, E. P., Scheuermann, T. S., Faseru, B., & Richter, K. P. (2019). Critical steps in the path to using cessation pharmacotherapy following hospital-initiated tobacco treatment. BMC health services research, 19(1), 246.
dc.descriptionThis work is licensed under a Creative Commons Attribution 4.0 International License.en_US
dc.description.abstractBackground Hospital-initiated smoking cessation interventions utilizing pharmacotherapy increase post-discharge quit rates. Use of smoking cessation medications following discharge may further increase quit rates. This study aims to identify individual, smoking-related and hospitalization-related predictors of engagement in three different steps in the smoking cessation pharmacotherapy utilization process: 1) receiving medications as inpatient, 2) being discharged with a prescription and 3) using medications at 1-month post-hospitalization, while accounting for associations between these steps.

Methods Study data come from a clinical trial (N = 1054) of hospitalized smokers interested in quitting who were randomized to recieve referral to a quitline via either warm handoff or fax. Variables were from the electronic health record, the state tobacco quitline, and participant self-report. Relationships among the predictors and the steps in cessation medication utilization were assessed using bivariate analyses and multivariable path analysis.

Results Twenty-eight percent of patients reported using medication at 1-month post-discharge. Receipt of smoking cessation medications while hospitalized (OR = 2.09, 95%CI [1.39, 3.15], p < .001) and discharge with a script (OR = 4.88, 95%CI [3.34, 7.13], p < .001) were independently associated with medication use at 1-month post-hospitalization. The path analysis also revealed that the likelihood of being discharged with a script was strongly influenced by receipt of medication as an inpatient (OR = 6.61, 95%CI [4.66, 9.38], p < .001). A number of other treatment- and individual-level factors were associated with medication use in the hospital, receipt of a script, and use post-discharge.

Conclusions To encourage post-discharge smoking cessation medication use, concerted effort should be made to engage smokers in tobacco treatment while in hospital. The individual and hospital-level factors associated with each step in the medication utilization process provide good potential targets for future implementation research to optimize treatment delivery and outcomes.
dc.description.sponsorshipNational Heart, Lung, and Blood Institute (U01 HL105232)en_US
dc.rights© The Author(s). 2019en_US
dc.subjectSmoking cessationen_US
dc.subjectMedication reconciliationen_US
dc.subjectTobacco use cessation devicesen_US
dc.subjectPatient dischargeen_US
dc.titleCritical steps in the path to using cessation pharmacotherapy following hospital-initiated tobacco treatmenten_US
kusw.kuauthorLiebmann, Edward P.
kusw.oaversionScholarly/refereed, publisher versionen_US
kusw.oapolicyThis item meets KU Open Access policy criteria.en_US

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© The Author(s). 2019
Except where otherwise noted, this item's license is described as: © The Author(s). 2019