Home > Medical student INtervention to promote effective nicotine dependence and tobacco HEalthcare (MIND-THE-GAP): single-centre feasibility randomised trial results.

Kumar, Anusha and Ward, Kenneth D and Mellon, Lisa and Gunning, Miriam and Stynes, Sinead and Hickey, Anne and Conroy, Ronán and MacSweeney, Shane and Horan, David and Cormican, Liam and Sreenan, Seamus and Doyle, Frank (2017) Medical student INtervention to promote effective nicotine dependence and tobacco HEalthcare (MIND-THE-GAP): single-centre feasibility randomised trial results. BMC Medical Education , 17 , (1) , p. 249.

URL: http://www.lenus.ie/hse/handle/10147/622716

BACKGROUND
Although brief cessation advice from healthcare professionals increases quit rates, smokers typically do not get this advice during hospitalisation, possibly due to resource issues, lack of training and professionals' own attitudes to providing such counselling. Medical students are a potentially untapped resource who could deliver cessation counselling, while upskilling themselves and changing their own attitudes to delivering such advice in the future; however, no studies have investigated this. We aimed to determine if brief student-led counselling could enhance motivation to quit and smoking cessation behaviours among hospitalised patients.

METHODS
A mixed-methods, 2-arm pilot feasibility randomised controlled trial with qualitative process evaluation enrolled 67 hospitalised adult smokers, who were recruited and randomized to receive a brief medical student-delivered cessation intervention (n = 33) or usual care (n = 34); 61 medical students received standardised cessation training and 33 were randomly assigned to provide a brief in-hospital consultation and follow-up support by phone or in-person one week post-discharge. Telephone follow-up at 3- and 6-months assessed scores on the Motivation to Stop Smoking Scale (MTSS; primary outcome) and several other outcomes, including 7-day point prevalent abstinence, quit attempts, use of cessation medication, and ratings of student's knowledge and efficacy. Data were analysed as intention to treat (ITT) using penalised imputation, per protocol, and random effects repeated measures. Focus group interviews were conducted with students post-intervention to elicit their views on the training and intervention process.

RESULTS
Analyses for primary and most secondary outcomes favoured the intervention group, although results were not statistically significant. Point prevalence abstinence rates were significantly higher for the intervention group during follow-up for all analyses except 6-month ITT analysis. Fidelity was variable. Patients rated students as being "very" knowledgeable about quitting and "somewhat" helpful. Qualitative results showed students were glad to deliver the intervention; were critical of current cessation care; felt constrained by their inability to prescribe cessation medications and wanted to include cessation and other behavioural counselling in their normal history taking.

CONCLUSIONS
It appears feasible for medical students to be smoking cessation interventionists during their training, although their fidelity to the intervention requires further investigation. A definitive trial is needed to determine if medical students are effective cessation counsellors and if student-led intervention could be tailored for other health behaviours.


Item Type:Article
Date:December 2017
Page Range:p. 249
Publisher:BioMed Central
Volume:17
Number:1
EndNote:View
Accession Number:HRB (Electronic Only)
Subjects:B Drugs and alcohol substances > Tobacco (cigarette smoking)
HJ Treatment method > Drugs and alcohol disorder treatment method > Cessation of drugs and alcohol use
J Health care, prevention and rehabilitation > Health care programme or facility > Hospital
N Communication, information and education > Educational environment (school / college) > Student behaviour and participation
VA Geographic area > Europe > Ireland

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