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Wilker OG, Stevens ER, Gold HT, Haber Y, Slover JD, Sherman SE. Implementation of a relapse prevention program among smokers undergoing arthroplasty: lessons learned. ANZ J Surg 2023; 93:1001-1007. [PMID: 36852876 DOI: 10.1111/ans.18354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 01/27/2023] [Accepted: 02/15/2023] [Indexed: 03/01/2023]
Abstract
BACKGROUND Surgery is a potent motivator to help people quit smoking to reduce the risk of complications. Many patients who smoke receive tobacco cessation counseling prior to surgery and are able to quit, but do not receive the same resources after surgery and often resume smoking. METHODS We present a case study describing the recruitment process, study components, and lessons learned from StayQuit, a comprehensive relapse prevention program designed to prevent relapse after arthroplasty. Lessons learned were examined post hoc to determine challenges related to program implementation, using existing study procedures and information collected. RESULTS While a comprehensive postoperative relapse prevention program may be beneficial to patients, implementation of StayQuit is unlikely to be feasible under current circumstances. The primary challenges to successful implementation of StayQuit focused on themes of lack of engagement in the preoperative Orthopedic Surgery Quit Smoking Program (OSQSP) and an environment unfavorable to in-person enrollment on the day of surgery. CONCLUSIONS Postoperative relapse prevention programs may be beneficial for patients who quit smoking prior to elective surgery. To help guide implementation, it is important to consider surgeon behavior, the collaboration of clinical and non-clinical teams, and best practices for study enrollment in surgical settings.
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Affiliation(s)
- Olivia G Wilker
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
| | - Elizabeth R Stevens
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
| | - Heather T Gold
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA.,Department of Orthopedic Surgery, NYU Grossman School of Medicine, New York, New York, USA
| | - Yaa Haber
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
| | - James D Slover
- Department of Orthopedic Surgery, NYU Grossman School of Medicine, New York, New York, USA
| | - Scott E Sherman
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA.,Department of Medicine, VA New York Harbor Healthcare System, New York, New York, USA
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Haber Y, Fu SS, Rogers E, Richter K, Tenner C, Dognin J, Goldfeld K, Gold HT, Sherman SE. A novel opt-in vs opt-out approach to referral-based treatment of tobacco use in Veterans Affairs (VA) primary care clinics: A provider-level randomized controlled trial protocol. Contemp Clin Trials 2022; 116:106716. [PMID: 35276337 DOI: 10.1016/j.cct.2022.106716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 02/17/2022] [Accepted: 02/23/2022] [Indexed: 11/18/2022]
Abstract
To determine whether an opt-out approach is effective for referral to treatment for tobacco use, we designed a clinical reminder for nurses in a primary care setting that provides a referral for patients who smoke cigarettes. We will use a two-arm, cluster-randomized design to assign nurses at the VA New York Harbor Healthcare System to test which mode of referral (opt-in vs opt-out) is more effective. All patients will be referred to evidence-based treatment for tobacco cessation including counseling from the New York State Quitline, and VetsQuit, a text messaging-based system for tobacco cessation counseling. We will measure patient engagement with the referral both in the short and long term to determine if referral modality had an impact on tobacco cessation treatment. We will also measure nurse engagement with the referral before, during, and after the implementation of the reminder to determine whether an opt-out approach is cost effective at the health system level. At the conclusion of this project, we expect to have developed and tested an opt-out system for increasing tobacco cessation treatment for Veterans in VA primary care and to have a thorough understanding of factors associated with implementation. Trial Registration:Clinicaltrials.govIdentifierNCT03477435.
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Affiliation(s)
- Yaa Haber
- VA New York Harbor Healthcare System, New York, NY, USA; Department of Medicine, VA New York Harbor Healthcare System, New York, NY, USA; NYU Grossman School of Medicine, Department of Population Health, New York, NY, USA.
| | - Steven S Fu
- Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Erin Rogers
- VA New York Harbor Healthcare System, New York, NY, USA; NYU Grossman School of Medicine, Department of Population Health, New York, NY, USA
| | - Kim Richter
- Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, KS, USA
| | - Craig Tenner
- VA New York Harbor Healthcare System, New York, NY, USA; NYU Grossman School of Medicine, Department of Medicine, New York, NY, USA
| | - Joanna Dognin
- VA New York Harbor Healthcare System, New York, NY, USA; NYU Grossman School of Medicine, Department of Medicine, New York, NY, USA; Department of Psychology, VA New York Harbor Healthcare System, New York, NY, USA
| | - Keith Goldfeld
- VA New York Harbor Healthcare System, New York, NY, USA; NYU Grossman School of Medicine, Department of Population Health, New York, NY, USA
| | - Heather T Gold
- VA New York Harbor Healthcare System, New York, NY, USA; NYU Grossman School of Medicine, Department of Population Health, New York, NY, USA
| | - Scott E Sherman
- VA New York Harbor Healthcare System, New York, NY, USA; NYU Grossman School of Medicine, Department of Population Health, New York, NY, USA; NYU Grossman School of Medicine, Department of Medicine, New York, NY, USA
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Knox A, Favre M, Haber Y, Falvo M, Serrador J. Cerebral Autoregulation and Cerebrovascular Reactivity is Similar in African American And Caucasian Males Despite Different Blood Pressures and Anterior Cerebral Artery Flow Velocities. FASEB J 2018. [DOI: 10.1096/fasebj.2018.32.1_supplement.lb323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Allan Knox
- Pharmacology, Physiology, and NeuroscienceRutgers New Jersey Medical SchoolNewarkNJ
| | - Michelle Favre
- Pharmacology, Physiology, and NeuroscienceRutgers New Jersey Medical SchoolNewarkNJ
| | - Yaa Haber
- Pharmacology, Physiology, and NeuroscienceRutgers New Jersey Medical SchoolNewarkNJ
| | - Michael Falvo
- Pharmacology, Physiology, and NeuroscienceRutgers New Jersey Medical SchoolNewarkNJ
| | - Jorge Serrador
- Pharmacology, Physiology, and NeuroscienceRutgers New Jersey Medical SchoolNewarkNJ
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