title: Improving the effectiveness of pharmacist-assisted tobacco cessation: a study of participant- and pharmacy-specific differences in quit rates.
abstract: BACKGROUND
  The New Mexico Pharmaceutical Care Foundation provided a pharmacist-assisted tobacco cessation program from 2004 to 2010. In evaluating the program, discrepant 6-month quit rates were observed between pharmacies.
  
  
  OBJECTIVE
  To identify participant- and pharmacy-specific factors associated with improved quit rates.
  
  
  METHODS
  To supplement data regarding participant characteristics and quit rates, semistructured interviews of 7 participating pharmacists were conducted. Multivariate logistic regression quantified associations between successful abstinence at 6 months and participant characteristics and pharmacy-specific factors.
  
  
  RESULTS
  Quit rates by pharmacy ranged from 1.1% to 59.4% (mean = 19.1%). There were 1235 participants enrolled at 7 pharmacies, and because of missing participant data, 883 were included in the quantitative analysis. Three pharmacy-specific characteristics distinguished 6-month success rates: number and duration of follow-ups and format of counseling sessions. Participants followed up at least 3 times were more likely to quit at 6 months than those contacted once or twice (odds ratio [OR] =4.9; 95% CI = 1.6-15.0). Compared with follow-ups of <15 minutes, longer durations of follow-ups were associated with higher success rates: 15 to 30 minutes, OR = 7.2, 95% CI = 3.7-14.3); >30 minutes, OR = 10.0, 95% CI = 3.5-28.9. Participants who attended group sessions were more likely to quit at 6 months than those who attended individual sessions: OR = 8.2; 95% CI = 2.8-23.9. Most pharmacists (88%) noted that participants' high or low commitment to quit was associated with success or failure, respectively. Several pharmacists (43%) noted difficulties with follow-up associated with participants' relapse. Time constraints were an obstacle noted by 70% of pharmacists.
  
  
  CONCLUSIONS
  Pharmacy-specific factors, including counseling format and program intensity, affected success.
authors.affiliation: University of Maryland Baltimore School of Pharmacy, Baltimore, MD, USA.
authors.forename: Xian
authors.initials: X
authors.lastname: Shen
authors.affiliation: University of New Mexico College of Pharmacy, Albuquerque, NM, USA Walgreens, Albuquerque, NM, USA.
authors.forename: Amy
authors.initials: A
authors.lastname: Bachyrycz
authors.affiliation: University of New Mexico College of Pharmacy, Albuquerque, NM, USA.
authors.forename: Joe R
authors.initials: JR
authors.lastname: Anderson
authors.affiliation: New Mexico Pharmaceutical Care Foundation, Albuquerque, NM, USA New Mexico Pharmacists Association, Albuquerque, NM, USA.
authors.forename: Dale
authors.initials: D
authors.lastname: Tinker
authors.affiliation: University of New Mexico College of Pharmacy, Albuquerque, NM, USA draisch@salud.unm.edu.
authors.forename: Dennis W
authors.initials: DW
authors.lastname: Raisch
mesh_terms: D000328:Adult; D001294:Attitude to Health; D003376:Counseling; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D009516:New Mexico / Q000453:epidemiology; D010593:Pharmaceutical Services / Q000592:standards / Q000706:statistics & numerical data; D010594:Pharmacies / Q000592:standards / Q000706:statistics & numerical data*; D010595:Pharmacists / Q000592:standards / Q000706:statistics & numerical data; D024382:Professional Role; D012008:Recurrence; D016540:Smoking Cessation / Q000191:economics / Q000379:methods* / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D013997:Time Factors; D061485:Tobacco Use Cessation Devices / Q000191:economics / Q000706:statistics & numerical data; D016896:Treatment Outcome; D055815:Young Adult
keywords: evaluation; pharmacists; quit rates; tobacco cessation