title: Smoking cessation interventions after acute coronary syndromes. Results of a cross-sectional survey in the Lazio Region of Italy.
abstract: Given the limited research on Italian hospital smoking care practices, a cross-sectional survey was undertaken in April-May 2011 to describe the current status of smoking cessation interventions for ACS patients in cardiovascular institutions of the Lazio Region of Italy. Lazio is a region of central Italy with a resident population of about 5,600,000. According to the data of the Regional Health Authority, about 10.000 patients are admitted for ACS every year in this region of Italy. Acute cardiac care in the region is currently provided by 33 Cardiology Divisions. All of these units were considered as eligible for the survey. The eligible respondent for each unit was the director. A self-report questionnaire was developed based on previous studies that examined the specific features of smoking cessation care provided to hospitalised patients. Questionnaires were forwarded by the Lazio Regional Section of the Italian National Association of Hospital Cardiologists (ANMCO). Completed questionnaires were received from 22 of the 33 eligible Divisions (66%). These 22 responding units currently provide acute care to about 70% of all ACS patients of the region. Responding units were more likely to represent public non-teaching hospitals (p = 0.002), while non-responders were mostly from private non-teaching institutions (p = 0.04). Response rates were not influenced by the presence of either interventional catheterization laboratory (Cathlab) or cardiac surgery within the hospitals. The survey suggest that most of cardiology units fail to provide recommended smoking care interventions to ACS patients. In particular, brief smoking cessation advice before discharge represents the only systematically implemented approach in clinical practice (22 units; 100%). Smoking cessation counselling is provided only in 9 units (40%). Specific pharmacotherapy is prescribed in selected case only in about one third of units (7 units; 32%), with varenicline being the preferred drug. Structural variables and organizational complexity have no influence on smoking care, as hospitals with Cathlab and cardiac surgery do not implement more effective strategies. Overall, this survey shows that the majority of smoking ACS inpatients may receive inadequate smoking care and that hospitals have considerable opportunity for improvement.
authors.affiliation: Cardiovascular Department, San Filippo Neri Hospital, Rome, Italy. f.colivicchi@sanfilipponeri.roma.it
authors.forename: Furio
authors.initials: F
authors.lastname: Colivicchi
authors.forename: David
authors.initials: D
authors.lastname: Mocini
authors.forename: Massimo
authors.initials: M
authors.lastname: Uguccioni
authors.forename: Stefano
authors.initials: S
authors.lastname: Strano
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Imperoli
authors.forename: Massimo
authors.initials: M
authors.lastname: Santini
mesh_terms: D054058:Acute Coronary Syndrome / Q000453:epidemiology / Q000534:rehabilitation*; D001552:Benzazepines / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D015438:Health Behavior; D019538:Health Care Surveys; D006293:Health Promotion; D006801:Humans; D007558:Italy; D018722:Nicotinic Agonists / Q000627:therapeutic use; D010351:Patient Discharge; D010818:Practice Patterns, Physicians'; D011810:Quinoxalines / Q000627:therapeutic use; D012907:Smoking / Q000453:epidemiology; D016540:Smoking Cessation / Q000706:statistics & numerical data; D000068580:Varenicline
chemical_list: D001552:Benzazepines; D018722:Nicotinic Agonists; D011810:Quinoxalines; D000068580:Varenicline