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HEALTHCARE PROVIDERS (PRESCRIBERS VS NONPRESCRIBERS) KNOWLEDGE OF TOBACCO-RELATED ISSUES INCLUDING DRUG INTERACTIONS WITH NICOTINE

North Shore-LIJ Center for Tobacco Control, Great Neck, NY

PURPOSE:Healthcare providers (HCPs) must understand the smoking cessation process to successfully treat patients for tobacco dependence. We have demonstrated previously that HCPs often advise patients to quit smoking but rarely assist patients through the quitting process. We reviewed the responses of "Prescribers" (NP, PA, MD, DO) vs. "Non-Prescribers" (Pharmacist, RN, Social worker, CASAC Counselor, Respiratory Therapist, and students) to an anonymous survey given to attendees prior to a full-day tobacco dependence treatment conference.

METHODS:IRB approved-anonymous surveys of questions regarding tobacco control issues: prevalence of smoking; tobacco treatment guidelines; cessation pharmacotherapy; interaction of nicotine with other drugs; symptoms and implications of nicotine withdrawal. Surveys were evaluated using SAS®.

RESULTS:600 healthcare providers (322 Prescribers) and (278 Non-Prescribers) participated. 6% Prescribers and 5% Non-Prescribers knew the AHRQ treatment guidelines for tobacco dependence; 16% Prescribers and 8% Non-Prescribers knew which FDA-approved medications were OTC and which were prescription (p=0.002). 1% of Prescribers and 3% Non-Prescribers correctly identified the signs of nicotine withdrawal. 45% Prescribers vs. 15% Non-Prescribers (p< 0.0001) knew seizures were contraindication for taking Bupropion. 48% of Prescribers and 34% of Non-Prescribers (p=0.001) answered true to "insulin requirement decreases with cessation of smoking," 28% of Prescribers and 33% of Non-Prescribers answered correctly, true to "requirements for Warfarin are less with the cessation of smoking," 78% Prescribers and 60% Non-Prescribers (p<0.0001) said they advised patients to quit at every visit. Success with getting patients to quit was reported by 39% Prescribers vs. 12% Non-Prescribers (p<0.0001).

CONCLUSION:HCP implementation and knowledge of the guidelines for treating tobacco dependence needs improvement. Awareness of the implications of abrupt cessation in the hospitalized patient will result in improved patient safety goals, such as decreased adverse drug reactions and health outcomes.

CLINICAL IMPLICATIONS:Public health efforts must be directed towards educating HCPs about the tobacco dependence treatment and cessation process leading to improved smoking cessation outcomes.

DISCLOSURE:Virginia Reichert, No Financial Disclosure Information; No Product/Research Disclosure Information