REPORT NUMBER OF QUIT ATTEMPTS BY DRUG TREATMENT: SCOTLAND; 2009/10 - 2015/16
health problems experienced no greater rates of psychiatric side-effects with Champix than the general population. For this reason, PGDs to supply Champix are very much easier to use with the number of exclusions and cautions for use being much smaller than previously.
ISD Scotland
cessation services, which offer more intensive support.
Of the drug treatments utilised In 2015/16, 47,664 (74 per cent) of quit attempts involved the use of NRT either as a single product (15,443, 24 per cent) or as part of a combination of more than one NRT product (32,202, 50 per cent). The decline in the number of quit attempts using NRT as a single product continued mainly because the use of single product NRT is less likely to address nicotine cravings, particularly in moderate to heavy smokers and is not recommended. However, the use of NRT in combination increased marginally (one per cent) for the fi rst time in two years (fi gure 23).
The results from this report reiterated that pharmacists are at the forefront of smoking cessation services and best positioned to provide patients with the behavioural advice and pharmacological aids to quit. Speaking with community pharmacists involved in the service, and also those working behind the scenes, they shared their thoughts and opinions on the service and also what is needed to maximise participation and produce results; stating that improvements are needed going forward to improve the programme for both patients and pharmacists alike.
James Griffi ths (Health care development manager for Nicorette at Johnson & Johnson) believes that the service limitations may need to be addressed in order to enhance the scheme.
‘While in terms of maximising participation in the service, the majority of pharmacies already display visual aids which advertise the programme,’ James said, ‘more
22 - SCOTTISH PHARMACIST
encouragement is needed with staff to engage smokers and increase their awareness of the free programme using the ask, advise assist model to provide brief advice and interventions.
‘In terms of moving the service forward, as highlighted by the ISD report, there is a slight but defi nite decline in participation in the scheme, so, in order to reverse this, the service needs to become more collaborative with other healthcare professionals in order to move towards a liaised service with GPs and hospitals. This can be achieved by referrals from GPs or hospitals directly into the pharmacy service, with allocated time set aside in order to run and manager a smoking cessation clinic. Pathways are needed to be tailored and developed as part of Transforming Your Care (TYC) to include referral into the stop smoking service.
‘The time period for a patient who initially fails to quit when reapplying to the scheme could be reviewed in order to maximise participation and eventual success rates, as approximately two thirds of current smokers say they want to quit. However, as nicotine is a highly addictive substance, the desire to quit is very often not enough, and the majority of smokers will attempt to break the addiction several times before achieving their aim, and therefore should be permitted to try again if they feel confi dent to do so without waiting a period of six months.’
The potential for helping smokers in primary care is enormous, with UK community pharmacists coming into contact with six million people each day.
Andrew Radley, Consultant in Public Health Pharmacy at Tayside Health
Board has a number of suggestions on how community pharmacy smoking cessation services could become more effective and help develop the pharmacy business.
‘Clients value the support they get from building a good relationship with the pharmacy team and through seeing the same member of the pharmacy team each time. If a member of your team has an interest in smoking cessation, you should develop their skills in behavioural support and motivational interviewing. The main reason that non-pharmacy services achieve higher quit rates than pharmacy services is around differences in the intensity of behavioural support that is offered; non-pharmacy services keep more patients for longer. Pharmacies that improve the experience that smoking cessation clients receive enhance their reputation and generate more enquiries about stopping smoking.
‘Pharmacies are in a fantastic position to talk to people about stopping smoking. I just don’t accept that the activity within the service should be falling. We are absolutely clear that people receiving prescriptions for medicines to treat their respiratory illnesses, cardiovascular disease, diabetes and mental health problems would have better health if they stopped smoking. Some pharmacies in Tayside now use their contact with these patients to raise the issue of smoking and have seen recruitment increase signifi cantly.
‘In Scotland, community pharmacies should be offering Varenicline to smoking cessation patients. Since the EAGLES study, we know that the Black Triangle has been removed from the product. The EAGLES study showed that people with mental
‘The latest statistics for NHS Stop smoking services in England show that the products smoking cessation patients now use has changed signifi cantly. Community pharmacies need to ensure that the service they offer provides the support that is most valued by patients. The English statistics showed that the greatest number of quitters used a patch and an unlicensed nicotine-containing product, such as an e-cigarette. The next largest group of quitters used Champix. There are lots of opportunities for pharmacies to listen to the patients who use their service and adapt the service they offer to meet their needs.’
Andrew believes that community pharmacies are in a strong position to make a real difference to tobacco control.
‘Pharmacies offer more smoking cessation than any other service in Scotland. Patients vote with their feet and the statistics clearly show which services are most valued. Pharmacies are a vital local service and form part of the key infrastructure within local communities. There are challenges for pharmacies in adapting their services to meet client needs and in improving the quality of the behavioural support they provide.
‘There are big advantages for pharmacies in collaborating with their local smoking cessation teams at the Health Board. These teams can provide training and help make links with other services for referrals and support. Moving towards a more collaborative service with other healthcare professionals is a start, and, where possible, allocated time to manage this would deliver better results. One thing that we cannot underestimate is not only the potential of the service itself to make a difference to a smoker’s health, but also the potential of the pharmacist as the expert on the high street to make an impact through our knowledge, expertise and skills on our patients.’ •
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48