Smoking Cessation Liz Grant Lead Public Health Pharmacist NHS Greater Glasgow & Clyde
Background <ul><li>Smoking remains the single biggest cause of preventable ill health </li></ul><ul><li>Increasing smoking...
Background <ul><li>Death from CHD is 50% higher in smokers (> 75% higher in heavy smokers) </li></ul><ul><li>30,600 deaths...
Benefits of quitting <ul><li>After one year, the excess risk of coronary heart disease caused by smoking is reduced by hal...
Cycle of Change (1)
Cycle of Change (2) <ul><li>Pre-contemplation   </li></ul><ul><ul><li>Smokers in this stage have not yet considered quitti...
Cycle of Change (3) <ul><li>Action </li></ul><ul><ul><li>The cessation attempt is put into action  </li></ul></ul><ul><li>...
<ul><li>How is it done in practice? </li></ul>
Keep Well <ul><li>&quot;the availability of good medical care tends to vary inversely with the needs of the population ser...
Keep Well- The Aim <ul><li>Strengthen the primary care services in the most deprived areas in Scotland   </li></ul>
What can Pharmacy Do? <ul><li>In NHS GG&C, introduced Long Term Medicines Service </li></ul><ul><li>Support to patients wi...
How was the Review Conducted <ul><li>15-20 minutes </li></ul><ul><li>Patient chooses medicine to discuss </li></ul><ul><ul...
North CHCP <ul><li>February 2007-March 2010 </li></ul><ul><li>26 pharmacies  </li></ul><ul><li>460 patients  </li></ul><ul...
Impact of  LTMS <ul><li>Two years before starting the LTMS, the quantities were insufficient in 68% of cases  </li></ul><u...
Conclusion <ul><li>Embed learning points into CMS </li></ul><ul><li>Good communication skills pertinent to both services <...
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Public health pre reg presentation 240211

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Public health pre reg presentation 240211

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

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