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Public health pre reg presentation 240211
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Public health pre reg presentation 240211






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    Public health pre reg presentation 240211 Public health pre reg presentation 240211 Presentation Transcript

    • Smoking Cessation Liz Grant Lead Public Health Pharmacist NHS Greater Glasgow & Clyde
    • Background
      • Smoking remains the single biggest cause of preventable ill health
      • Increasing smoking cessation rates represents one of the largest health challenges
    • Background
      • Death from CHD is 50% higher in smokers (> 75% higher in heavy smokers)
      • 30,600 deaths or 27% of all smoking attributable deaths in the UK were due to cardiovascular disease
      • After the NS Ban, hospitals saw a 17% reduction in heart attack admissions
    • Benefits of quitting
      • After one year, the excess risk of coronary heart disease caused by smoking is reduced by half
      • Male smokers who quit between 35 and 39 years add an average of 5 years to their lives
      • Female quitters add 3 years
      • If you've had a heart attack, quitting smoking reduces your risk of a subsequent one by 25%
    • Cycle of Change (1)
    • Cycle of Change (2)
      • Pre-contemplation
        • Smokers in this stage have not yet considered quitting
      • Contemplation
        • Smokers in this stage are thinking about stopping
      • Determination
        • Smokers in this stage are ready to make a cessation attempt
    • Cycle of Change (3)
      • Action
        • The cessation attempt is put into action
      • Maintenance
        • Maintain a smoke-free patient
      • Relapse
        • Support the smoker and help them learn from the cessation attempt
      • How is it done in practice?
    • Keep Well
      • "the availability of good medical care tends to vary inversely with the needs of the population served .“ Julian Hart,1971
      • the healthcare services are most likely to be accessible to those who need it less
      • Scottish Executive funded an anticipatory care service in areas of the greatest need
        • to reduce health inequalities by focusing on populations considered to have high risks of CHD and diabetes
    • Keep Well- The Aim
      • Strengthen the primary care services in the most deprived areas in Scotland
    • What can Pharmacy Do?
      • In NHS GG&C, introduced Long Term Medicines Service
      • Support to patients with CHD or diabetes on four or more medicines
      • Monthly reviews
      • North, East & SW Glasgow
    • How was the Review Conducted
      • 15-20 minutes
      • Patient chooses medicine to discuss
        • What is it for? Open package? Miss a dose?
      • Refer/signpost to other services
        • Money Matters; Employability; Smoking Cessation; Alcohol
    • North CHCP
      • February 2007-March 2010
      • 26 pharmacies
      • 460 patients
      • 85% (392 patients) have received their first review
      • 51% (235) have received six reviews.
      • A total of 3,796 reviews were delivered
    • Impact of LTMS
      • Two years before starting the LTMS, the quantities were insufficient in 68% of cases
      • Reduced to 27.5% one year after the first LTMS review
      • Improved perceived patient compliance
      • Increased medication awareness
    • Conclusion
      • Embed learning points into CMS
      • Good communication skills pertinent to both services
      • Body language, empathy, listening but not judging, confidence in raising the issue
      • Someone to talk to, especially for elderly patients