Smokers Hospitalized for CHD Rarely Receive Cessation Pharmacotherapy During Hospitalization

Few smokers hospitalized for the treatment of coronary heart disease (CHD) receive smoking cessation pharmacotherapy (SCP) during their hospitalization according to a research letter published August 21 in JAMA: Internal Medicine.

Researchers Quinn R. Pack, MD, MSc, FACC, et al., conducted a retrospective study of 282 U.S. hospitals, observing active smokers admitted with a principal diagnosis of myocardial infarction or who received percutaneous coronary intervention or coronary artery bypass surgery. Data analysis showed that between 2004 and 2011, there was a 6 percent increase in mean hospital SCP receipt rate, but only a 2 percent increase from 2011 and 2014.

Among 36,675 smokers with CHD, roughly 23 percent received at least one SCP during hospitalization. Overall, more than 40 percent of participating hospitals administered SCP to fewer than 20 percent of eligible patients. At approximately 20 percent, the nicotine patch was the most commonly prescribed method. Additional therapies, including nicotine gum, lozenge, inhaler, bupropion and varenicline combined made up less than 4 percent of SCP prescriptions.

"Hospitalization for a cardiac event provides a teachable moment with high patient motivation to quit smoking; however, our findings suggest that many hospitals are missing this opportunity to improve outcomes for smokers hospitalized for CHD," write Pack, et al. "We hope these results will encourage physicians and hospital administrators to evaluate local practice patterns and consider quality improvement initiatives to provide every smoker the necessary support to quit permanently."

Clinical Topics: Prevention, Smoking

Keywords: Smoking Cessation, Smoking, Bupropion, Nicotine, Quality Improvement, Tobacco Use Cessation Products, Coronary Disease, Hospitalization, Nebulizers and Vaporizers

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