SHM Converge Scientific Abstract ePoster Gallery-Inpatient Varenicline for Smoking Cessation in Copd Patients

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This project evaluated whether hospitalists starting varenicline during admission could improve smoking cessation in patients with COPD.<br /><br />Background: Smoking cessation lowers mortality in COPD, and varenicline is considered the most effective medication for quitting. The American Thoracic Society recommends it even for patients who are not yet ready to stop smoking. Starting treatment in the hospital may help because patients are temporarily unable to smoke, are available for counseling, and face fewer barriers to beginning therapy.<br /><br />Methods: The intervention was implemented across three hospital sites through collaboration between Pulmonary and Hospital Medicine teams. Each day, a list was generated in the electronic health record of hospitalized COPD patients who smoked. Hospitalist teams were notified and used an opt-out approach to counsel patients and initiate varenicline during admission. Patients who accepted treatment were discharged with a varenicline prescription and referred to a smoking cessation clinic. Outcomes were assessed using chart review and follow-up phone calls.<br /><br />Results and conclusion: Hospitalist initiation of varenicline plus discharge prescribing was associated with improved smoking cessation at one year. Among living patients, 17% had quit smoking, and 22.2% had either quit or were smoking less after one year. This compares favorably with prior studies showing about 15% tobacco abstinence at 12 months after discharge. The authors note that an opt-out model may allow more eligible patients to receive varenicline, and that the inpatient team’s direct relationship with patients may be more effective than automated interventions. They recommend expanding this approach to more sites and other patient populations, such as cardiac patients.

Asset Subtitle

Faye E. Reiff-Pasarew

Meta Tag

Author List Faye E. Reiff-Pasarew, Jana Hurta, Jennifer R. Antretter, Mary M. O'Sullivan

Category Research

Concept Chronic Obstructive Pulmonary Disease

Concept Smoking Cessation

Concept Varenicline

Concept Mortality

Concept Hospitalization

Distinguished Non-Finalist

Presenter Organization Mount Sinai Morningside Hospital, Icahn School of Medicine at Mount Sinai

Presenting Author Faye E. Reiff-Pasarew

Track Quality Improvement

Keywords

varenicline

smoking cessation

COPD

hospitalists

inpatient initiation

hospital admission

opt-out counseling

discharge prescription

tobacco abstinence

smoking cessation clinic

Chronic Obstructive Pulmonary Disease

Smoking Cessation

Varenicline

Mortality

Hospitalization