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2002 DVA Pharmacy Conference |
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Julianne E. Himstreet, Pharm.D., Eugene Community Based Outpatient Clinic, Daniel Neal, Pharm.D., Roseburg VA Health Care System, Kenny Har, Pharm.D., Roseburg VA Health Care System.
Statement of issue
Innovations in collaborative practice.
This report documented the clinical outcomes of a pharmacist managed tobacco
cessation program at three Veterans Administration outpatient clinics.
ACTION PLAN
IMPLEMENTED
Data for tobacco cessation rates were collected from 205 participants enrolled
in tobacco cessation courses facilitated by clinical pharmacists from November
1, 2000 to November 1, 2001. Participants in the tobacco cessation course
attended 6 classes based on the American Lung Association Freedom from Smoking
program. Upon completion of the course, the participants chose to use either
the nicotine patch (21mg/day for 4 weeks, 14mg/day for 2 weeks, 7mg/day for 2
weeks), bupropion SR (Zyban 150mg twice a day for 9 weeks) or to quit without
medication. Follow up classes occurred every 2 weeks for a total of 8 weeks
after the tobacco quit day. Tobacco cessation rates were collected at 8 weeks,
3 months, 6 months and 12 months after quitting tobacco products.
OUTCOMES
Nicotine patches were prescribed for 136 participants, bupropion for 54
participants and 15 participants attempted to quit without medications. After 8
weeks, 64 participants (47%) using the nicotine patch, 31 participants (58%)
using bupropion, and 6 participants (40%) using no medications had quit tobacco
products. Cessation rates 3 months and 6 months after quit day were 36% and 35%
respectively for the group using nicotine patches, 50% and 38% for the group
using bupropion, and 40% and 33% for those not using medications. After 12
months the cessation rates were 30% (21/70) for the nicotine patch group, 41%
(14/34) for the bupropion group, and 23% (3/13) for the group not using
medications.
CONCLUSIONS
Preliminary results from this program show successful tobacco cessation rates
using nicotine patches, bupropion or no medications when these modalities were
combined with classes addressing behavior modification.
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