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Background
Cigarette smoking is one of the major preventable causes of death and diseases in Qatar. The study objective was to test the effect of a structured smoking cessation program delivered by trained pharmacists on smoking cessation rates in Qatar. MethodsA prospective randomized controlled trial was conducted in eight ambulatory pharmacies i...
Context in source publication
Context 1
... February 2013 and December 2014, the study pharmacists assessed 450 smokers for eligibility in the study. Of them, 361 (80.2%) met the study inclusion cri- teria. A total of 314 cigarette smokers consented to en- roll in the study and were randomized into one of two study groups (Fig. 1). Of 167 participants in the inter- vention group, 55% completed two pharmacy visits. Two patients in the intervention group could not tolerate NRT and as a result they were excluded by the study ...
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Purpose:
To evaluate the awareness of cigarette smoking as a risk factor for chronic periodontitis in patients either undergoing active periodontal treatment (APT) or enrolled in supportive periodontal therapy (SPT).
Materials and methods:
Comprehensive tobacco use history was collected with a questionnaire in 50 patients before and after APT (t...
Citations
... Different studies were performed or planned 128,129 to evaluate the implementation of tobacco quitting activities (consultation, provision of nicotine patch or immediate-release bupropion) and found these interventions feasible 130,131 as well as effective. 131,132 On the other hand, some authors did not prove the intervention´s feasibility. 133 Apart from some achievements in the field, mental disorder patient-centred pharmaceutical interventions are challenging as such a service requires a unique and time-consuming approach. ...
... Furthermore, 2.3% of the studies related to the managing of Cardio Vascular Diseases [54][55][56](CVDs), while 2.3% of the studies focused on the intervention on patients with Chronic Kidney Diseases (CKDs) [10, 57, 58] and 1.5% of the studies described the implementation of PCs in patients with respiratory diseases such as asthma [59,60]. All of them substantiated that pharmacists/ clinical pharmacists are an essential part of the health care team to provide early detection of chronic diseases, managing associated complications, and how the physicians strongly recommended the importance of integrating the pharmaceutical care services. ...
Introduction
Pharmaceutical care services (PCs) have evolved significantly over the last few decades, with a greater focus on patient’s safety and proven effectiveness in a wide range of contexts. Many of the evidence supporting this technique comes from the United States, the evaluation and adoption of (PCs) which differ greatly across the globe.
Objective
The goal of this study was to identify and assess the efficacy of pharmaceutical care services in various pharmaceutical aspects throughout seventeen Middle Eastern nations.
Method
The Arkesy and O’Malley technique was used to conduct a scoping review. It was conducted using PubMed/Medline, Scopus, Cochrane Library, Springer Link, Clinical Trials, and Web of Science etc. The Van Tulder Scale was utilized in randomized trials research, whereas the dawn and black checklists were used in non-randomized trials research. A descriptive and numerical analysis of selected research was done. The scope of eligible PCs, pharmaceutical implementers, study outcomes, and quality were all identified by a thematic review of research.
Results
There were about 431,753 citations found in this study, and 129 publications were found to be eligible for inclusion after analysing more than 271 full-text papers. The study design was varied, with 43 (33.3%) RCTs and 86 (66.7%) n-RCTs. Thirty-three (25.6%) of the studies were published in 2020. Jordan, Saudi Arabia, and Turkey were home to the majority of the studies (25.6%, 16.3%, and 11.6%) respectively. Thirty-seven studies (19.7%) were concerned with resolving drug related problems (DRPs), whereas 27 (14.4%) were concerned with increasing quality of life (QOL) and 23 (12.2%) with improving drug adherence. Additionally, the research revealed that the average ratings of the activities provided to patients improved every year.
Conclusion
Studies in the Middle East continue to provide evidence supporting the positive impact of pharmaceutical care services on both hard and soft outcomes measured in most studies. Yet there was rare focus on the value of the implemented services. Thus, rigorous evaluation of the economic impact of implemented pharmaceutical care services in the Middle East and assessment of their sustainability is must.
... In a previous survey of current smokers in Qatar, [18], 67% had expressed willingness to quit; however, the high prevalence of smokers highlights the need to bolster support for smoking cessation in the country [19,20]. In a prospective randomized control trial, El Hajj et al. compared the effectiveness of a face-to-face structured smoking cessation program conducted by trained pharmacists [21]. Our telephone-based cessation program was a feasibility, acceptability, and preliminary efficacy study conducted by trained behavioral counselors. ...
The steady increase in smoking rates has led to a call for wide-reaching and scalable interventions for smoking cessation in Qatar. This study examined the feasibility and acceptability of an evidence-based smoking cessation program delivered by telephone for Qatari residents. A total of 248 participants were recruited through primary care centers and received five weekly scheduled proactive behavioral counseling calls from personnel trained in tobacco cessation and navigation to obtain cessation pharmacotherapy from clinics. Outcomes were assessed at end of treatment (EOT), and 1- and-3-month follow up. The Mann–Whitney test was used to compare the average number of participants recruited per month pre- and post-COVID. We recruited 16 participants/month, the majority (85.5%) attended at least one counselling session, and 95.4% used some of pharmacotherapy. Retention rates were 70% at EOT, 64.4% and 71.7% at 1- and 3-month follow up, respectively; 86% reported being ‘extremely satisfied’ by the program. Our ITT 7-day point prevalence abstinence was 41.6% at EOT, 38.4% and 39.3% at 1-and 3-month, respectively. The average number of participants recruited per month was significantly higher for pre vs. post-COVID (18.9 vs. 10.0, p-value = 0.02). Average number of participants retained at EOT per recruitment month showed a slight decrease from 8.6 pre- to 8.2 post-COVID; average number who quit smoking at EOT per recruitment month also showed a decrease from 6 to 4.6. The study results indicated that our telephone-based intervention is feasible and acceptable in this population and presents a new treatment model which can be easily disseminated to a broad population of Qatari smokers.
... The outcomes and aims of the included studies are summarized in Table 3. The most commonly reported outcome was the quit rate (n=18) 36,37,40,[42][43][44][45][46][47][48][49][50][51][52][53][54][55][56] , followed by cessation rate (n=8) 39,41,[56][57][58][59][60][61] , sustained abstinence (n=1) 35 , fail to quit (n=1) 62 , cessation survival rate (n=1) 38 , and success rate (n=1) 35 . The majority of studies utilized a self-reported questionnaire to estimate quit rates, while some others used the carbon monoxide breath test to determine quitting state (n=19) 35-37,39-41,43,44,46-48,50-53, 55-57,59 . ...
... The organizational factors in our review were represented by the type of services provided in TC programs. Services that were linked to effective TC programs included using NRT 39 43,56 , providing advice through health professionals 45 , and use of harm reduction approach in the programs 55 . ...
Introduction:
In Middle East countries, the average prevalence of tobacco use is relatively high. This systematic review aimed to explore different tobacco cessation programs provided in the Middle East, identify healthcare professionals providing these programs, and the factors associated with their effectiveness.
Methods:
A systematic review was conducted using an electronic search of PubMed, EMBASE, Cochrane Library, ProQuest, and Web of Science, bibliographic databases between 24 January 2021 and 7 March 2021, to identify all relevant studies. The keywords used were 'tobacco cessation' and 'Middle East'. The review was undertaken applying the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines (PRISMA). Based on the study types, several quality assessment tools including the Cochrane risk of bias tool for randomized controlled trials, MINORS for quasi-experimental studies, NIH for cross-sectional studies, NIH for pre-post studies, and CASP for cohort studies, were used.
Results:
Among the 512 studies screened, only 30 were included in this review. Our systematic review identified different cessation methods, with some employing both behavioral change and pharmacological methods, and some utilizing only one method. Physicians are believed to be the most common providers of cessation programs, with only a few other healthcare professionals doing so. The results of this review revealed that several factors are associated with the effectiveness of tobacco cessation programs in the Middle East including individual, interpersonal, community, organizational, policy, and environmental.
Conclusions:
Future research should focus on examining the sociocultural and economic factors that might influence tobacco cessation programs. The included studies were of average to poor quality, highlighting the need to conduct highquality studies. The findings provide evidence to encourage the development of multilevel programs to improve the efficacy of tobacco cessation initiatives in the Middle East.
... En nuestro caso, el 71,4 % de los pacientes se mantenía sin fumar a las 12 semanas, si bien nuestros pacientes combinaron tanto la terapia farmacológica como la terapia conductual, cosa que no ocurrió en los pacientes de los estudios citados. Otros estudios ya han evidenciado que el añadir terapia conductual al tratamiento farmacológico incrementa en gran medida el éxito de la cesación tabáquica y que tanto el asesoramiento conductual como la farmacoterapia son más eficaces cuando se usan de forma combinada que cuando se usan individualmente (5,21,22), como ha ocurrido en nuestro programa. La combinación de estas dos formas de tratamiento fue del agrado de los pacientes que refirieron espontáneamente sentirse "más acompañados", "más seguros" y "más controlados" al incorporar la terapia conductual a la farmacológica. ...
... En general, los estudios revelan que la intervención farmacéutica, aun siendo breve, explicando al paciente los beneficios de dejar de fumar, dándole estrategias para hacerlo y discutiendo con él qué puede esperar durante todo el proceso, aumenta las tasas de cesación tabáquica en comparación con los grupos control (21,23,24). En nuestro caso, el disponer de una guía que facilitaba la programación de las visitas, la uniformidad del programa y el poder dar un contenido específico y diferente en cada visita nos permitió mantener el interés de los pacientes a lo largo de las doce semanas, sin limitarnos a la mera recogida de datos y manejo de efectos secundarios. ...
Objetivo: evaluar los resultados de la implementación de un programa multidisciplinar médico-farmacéutico de cesación tabáquica combinando vareniclina y terapia conductual.
Métodos: el médico de atención primaria valoró la dependencia y motivación del paciente para dejar de fumar mediante los test de Fagerström y Richmond, respectivamente. Los pacientes candidatos a entrar en el programa recibían la prescripción de vareniclina, si era necesaria, y se incorporaban a un programa de terapia conductual de tres meses de seguimiento en la farmacia comunitaria. Para el abordaje de la terapia conductual, el farmacéutico comunitario desarrolló una guía estructurada en 8 visitas y materiales de soporte para el paciente. El seguimiento de los pacientes se realizó en la farmacia comunitaria y el farmacéutico solo derivó a los pacientes a la consulta de atención primaria cuando aparecieron efectos adversos graves. Se recogió el historial de tabaquismo de los pacientes y sus comorbilidades, el tratamiento farmacológico recibido y sus efectos secundarios.
Resultados: se incluyeron 26 pacientes. La puntuación media del test de Richmond fue de 8,31 (DE 1,54). La puntuación media del test de Fagerström fue de 5,73 (DE 2,10). La salud fue el principal motivo para dejar de fumar. Los pacientes recibieron vareniclina como tratamiento farmacológico para dejar de fumar, 21 pacientes (80,8 %) completaron las 12 semanas de tratamiento. Del total de la muestra, 18 pacientes (69,2 %) se mantuvieron sin fumar durante 3 meses. Los efectos secundarios observados más frecuentes fueron insomnio y diarrea. La terapia conductual llevada a cabo por el farmacéutico ayudó a mantener la adherencia al tratamiento farmacológico y la motivación durante el proceso de cesación tabáquica.
Conclusión: el programa de cesación tabáquica basado en la colaboración médico - farmacéutico, con la combinación de terapia farmacológica y conductual y con la ayuda de una guía desarrollada específica-mente se mostró eficaz para dejar de fumar.
... The magnitude of the 7-day point abstinence rate in this study was similar to that of other pharmacist-led smoking cessation programs. A study in Qatar by Hajj et al. evaluated smoking cessation rates provided by pharmacists at 6 months and found a rate of 27.0% [30]. Gong et al. conducted an RCT study with participants who received pharmacist-provided telephone counseling and medications that revealed a 42.3% 1-week point abstinence rate at week 12, which was higher than the usual care rate of 38.2% (p > 0.05) [31]. ...
... One participant in the intervention group was diagnosed with cancer and decided to stop using the app. Other studies have shown that special characteristics, such as swearing to complete the study [28], much better compensation (90 US dollars per visit) [29], and effective medications (such as varenicline, bupropion, nicotine patch) [28][29][30][31] helped to increase app engagement and quit rates. Our study was performed ethically, and the participants could choose to leave the study at any time. ...
WHO supports the harnessing of mobile technologies to improve access to smoking cessation services. As such, this study evaluated the effectiveness of smoking cessation services provided by community pharmacists using PharmQuit compared with standard care. The study was a prospective, multicenter, randomized controlled trial that included 156 participants who were 18 years or older and smoked at least one cigarette daily for a month, were ready to quit, willing to participate, and had a smartphone. The study was performed at seven community pharmacies in three provinces in Thailand. Participants were allocated to the intervention (n = 78) and control groups (n = 78). Both groups received the usual smoking cessation services with pharmacotherapy and counseling from community pharmacists for 6 months. The intervention group received PharmQuit as an additional service. Both groups were scheduled for follow-up visits on days 7, 14, 30, 60, 120, and 180. The primary outcome was continuous abstinence rate on day 180. The secondary outcomes included 7-day point abstinence rate, number of cigarettes smoked per day, exhaled carbon monoxide levels, adherence rate to the program, and satisfaction with PharmQuit. An analysis using the intent-to-treat principle was performed. Smoking cessation rates and the number of cigarettes smoked per day were significantly higher during the follow-up visits in both groups (p < 0.05). However, there were no statistically significant differences between the two groups. The adherence rate to the smoking cessation program was higher in the intervention group than in the control group (74 days vs. 60 days, p > 0.05). The results showed the benefits of the contribution of community pharmacists. Although the inclusion of PharmQuit did not yield better results than pharmacists’ counselling alone, it may help obtain better adherence to smoking cessation programs.
Trial registration: Thai Clinical Trials Registry: TCTR20200925004 on September 25, 2020 –retrospectively registered, http://www.clinicaltrials.in.th/index.php?tp=regtrials&menu=trialsearch&smenu=fulltext&task=search&task2=view1&id=6841.
... The intensity of the cessation programmes seems to be of major importance for successful quitting. 35 Already, in the year of 2000, the term 'intensive smoking cessation intervention' was defined internationally as a face-to-face programme with at least 4 meetings of at least 10 min. 36 37 A non-intensive standard programme in the UK showed weak effect among low socioeconomic groups in real life setting. ...
Introduction
Tobacco is still one of the single most important risk factors among the lifestyle habits that cause morbidity and mortality in humans. Furthermore, tobacco has a heavy social gradient, as the consequences are even worse among disadvantaged and vulnerable groups. To reduce tobacco-related inequity in health, those most in need should be offered the most effective tobacco cessation intervention. The aim of this study is to facilitate and improve the evaluation of already implemented national tobacco cessation efforts, focusing on 10 disadvantaged and vulnerable groups of tobacco users.
Methods and analysis
This is a prospective cohort study. Data will be collected by established tobacco cessation counsellors in Sweden. The study includes adult tobacco or e-cigarette users, including disadvantaged and vulnerable patients, receiving in-person interventions for tobacco or e-cigarette cessation (smoking, snus and/or e-cigarettes). Patient inclusion was initiated in April 2020. For data analyses patients will be sorted into vulnerable groups based on risk factors and compared with tobacco users without the risk factor in question.
The primary outcome is continuous successful quitting after 6 months, measured by self-reporting. Secondary outcomes include abstinence at the end of the treatment programme, which could be from minutes over days to weeks, 14-day point prevalence after 6 months, and patient satisfaction with the intervention. Effectiveness of successful quitting will be examined by comparing vulnerable with non-vulnerable patients using a mixed-effect logistic regression model adjusting for potential prognostic factors and known confounders.
Ethics and dissemination
The project will follow the guidelines from the Swedish Data Protection Authority and have been approved by the Swedish Ethical Review Authority before patient inclusion (Dnr: 2019-02221). Only patients providing written informed consent will be included. Both positive and negative results will be published in scientific peer-reviewed journals and presented at national and international conferences. Information will be provided through media available to the public, politicians, healthcare providers and planners as these are all important stakeholders.
Trial registration number
NCT04819152 .
... Participants in the control group got informal, brief coaching about quitting smoking. [12]. The provision of cessation services by a pharmacist at a publicly financed QSC was linked to a high default rate. ...
... Be it global, national, state, regional, and institutional, the pharmacists have a responsibility to promote public health [66]. In this article review, several interventions have highlighted the emerging roles of community pharmacists on public health especially on smoking cessation [7][8][9][10][11][12][13][14], weight management [15][16][17][18]68], COVID-19 [58][59][60][61], chronic disease management [19][20][21][22][23][24][25]62], drug misuse prevention and management [26][27][28][29][30][31], and immunization and vaccination [32][33][34][35][36][37][38][39][40][41][42][43][44][45][46]. ...
... Interventions on smoking cessation led by the community pharmacists have significantly led to their decrease in daily cigarette consumption [7], increased their motivation to quit [8], and offered benefit in helping smokers quit smoking [13]. Although there are still studies indicating that pharmacists' role is not that effective in the smoking cessation of patients [9,14], there has been a lot of initiatives on improving community pharmacists competencies through community-based smoking cessation programs and training for the pharmacists [9,10,11,12]. Relevantly, it was highlighted that many undergraduate pharmacy schools in Malaysia presently incorporate education on smoking cessation, enabling community pharmacists with access to the principles of this branch of medicine [10]. ...
This study's aim was to conduct a comprehensive review of previously published research publications related to the emerging roles of community pharmacists in public health in Asia. It aims to analyze the new roles that community pharmacists are being called upon to fill in Asian regions in public health with also a focus on maximizing the full capacity of pharmacist skills and development to public health, a continuing advocate, and first-line empowerment of providing pharmacy information queries. The written works of this study utilized a systematic search of existing literature, including articles reporting on the emerging roles of community pharmacists in public health, using the following databases: Cochrane, Google Scholar, Science Direct, PubMed/Medline, and Research Gate. Hand searching relevant articles on the research topic were employed to help ensure the confinement of all necessary existing literature/articles. The intervention or services types are classified based on the following: smoking cessation services, weight management services, alcohol reduction services, chronic disease management, drug misuse prevention and management services, and immunization and vaccination services; each comprises different major processes aiming to improve an individual's health status providing ways upon validation that are crucial for the betterment of public healthcare. In accordance with the studies, community pharmacist-led public-health programs markedly strengthened the efficiency, steadfastness, and cost-effectiveness of the allocation of public health resources whilst still optimizing the health of clients and patients, specifically whenever it arrives at assessing prospective issues and individuals who seek specialized care. Notwithstanding such, community pharmacy operations still necessitate modification to satisfy the evolving demands of consumers of modern medications. Training must attempt to boost pharmacists' confidence in supplying these services if community pharmacies are to elevate the public health services they serve. A proactive approach to the delivery of public health care by confident, well-trained pharmacists should have a favorable impact on client attitudes and health.
... Despite their successful implementation and uptake as standard practice in Western countries, little research has examined the effectiveness of telephone-based quitline services in Qatar. A randomized control trial by El Hajj et al. in 2015 showed the efficacy of a pharmacist-delivered in-person smoking cessation intervention that focused on education and coping skills [17]. The study included three sessions out of which only the first provided behavioral counseling. ...
In Qatar, tobacco is the leading preventable cause of death and disease. Telephone-based interventions for smoking are cost-effective and scalable interventions that are effective in promoting smoking behavior change. While many countries have implemented these services within their tobacco control programs, there is a distinct dearth of a telephone-based smoking cessation intervention that is adapted and tailored to meet the needs of people who smoke in Qatar. This study presents the protocol of a primary health care center integrated smoking quitline program in Qatar. Participants will be recruited from seven smoking clinics (recruitment sites). Trained clinic staff will provide brief advice on quitting followed by a referral to the quitline. Eligible participants (male smokers over 18 years of age) will complete baseline questionnaires and receive five weekly proactive counseling calls, an end-of-treatment assessment (approx. 1 week after Session 5), and 1- and 3-month follow-up assessments. The main aim of this study is to assess the feasibility and acceptability, which include the recruitment and retention rate, compliance to pharmacotherapy, and participant satisfaction. This is the first study to integrate an evidence-based smoking cessation intervention delivered via telephone within the healthcare system in Qatar. If effective, results can inform the development of a large-scale telephone-based program that widely reaches users of tobacco in Qatar as well as in the Middle East.
... The magnitude of the quit rates in this study are similar to those of other pharmacist-led smoking cessation programs conducted elsewhere. One randomized controlled trial (RCT) study in Qatar by Hajj et al evaluated smoking cessation rates provided by pharmacists at 6 months and found a quit rate of 27.0% [25]. Gong et al did an RCT study with participants who received pharmacist-provided telephone counseling and medications showed a 42.3% 1-week point abstinence rate at week 12 which was higher than the usual care rate of 38.2% (p > 0.05) [26]. ...
... One participant in the intervention group was diagnosed with cancer and decided to stop using this app. Other studies have shown that special characteristics such as swearing to complete the study [22], much better compensation (90 US dollars per visit) [24], and effective medications (such as varenicline, bupropion, nicotine patch) [22,[24][25][26] helped to increase app engagement and quit rate. Our study was performed ethically and the participants could choose to leave the study at any time. ...
Background: WHO supports the harnessing of mobile technologies to improve access to smoking cessation services. PharmQuit, a smartphone app, was developed to support smoking cessation efforts by pharmacists taking into consideration the design of the app according to the needs of smokers. This study evaluated the effectiveness of smoking cessation services conducted by community pharmacists using PharmQuit compared with standard care.
Methods: An open-label prospective, randomized, controlled trial was conducted. Stratified random sampling by sex, age, and nicotine addiction was used to allocate participants to either the intervention group or control group. Eligible participants were smokers 18 years old or older who smoked at least one cigarette daily for a month, were ready to quit, willing to participate, and had a smartphone. The study was performed at seven community pharmacies situated in three provinces in Thailand. In the intervention group, participants received smoking cessation services by community pharmacists using PharmQuit. The control group received standard care delivered by community pharmacists. Both groups were scheduled follow-ups at day 7, 14, 30, 60, 120, and 180. The primary outcomes were quit rate and number of cigarettes smoked per day. Secondary outcomes were exhaled carbon monoxide levels, adherence rate to the program, and satisfaction with PharmQuit. Analysis using the intent-to-treat principle was carried out.
Results: A total of 156 smokers were randomly assigned to either the intervention (n=78) or control (n=78) group. Smoking cessation rates and the number of cigarettes smoked per day were significantly better over the follow-up visits in both groups (p<0.05). However, there were no statistically significant differences between the two groups. Adherence rate to the smoking cessation program was higher in the intervention group than the control group (74 days vs 60 days, p>0.05). Relapse rate was found to be lower in the intervention group as compared to the control group (28.6% vs 71.4%).
Conclusions: The results showed obvious benefits of the community pharmacist’s contribution in helping smokers quit smoking. PharmQuit was not better than just pharmacist’s counselling but it might help to obtain better adherence to smoking cessation programs, and have less likelihood of relapse.
Trial registration: Thai Clinical Trials Registry: TCTR20200925004. Registration date September 25, 2020 – Retrospectively registered, http://www.clinicaltrials.in.th/index.php?tp=regtrials&menu=trialsearch&smenu=fulltext&task=search&task2=view1&id=6841
