Background: Smoking cessation is an essential part of preventing and reducing the risk of smoking-associated morbidity and mortality. However, there is often little time to discuss smoking cessation in primary care. Decision aids (DAs) designed for clinic visits (encounter DAs) need to be clear, short, and concise to optimize therapeutic education, increase interaction, and improve the therapeutic alliance. Such a DA for smoking cessation could potentially improve counseling and increase the use of pharmacological treatments.
Objective: We aimed to collect feedback on an electronic encounter DA that facilitates physician-patient interaction and shared decision-making for smoking cessation in primary care.
Methods: We developed an electronic, encounter DA (howtoquit.ch) from a paper version created by our team in 2017 following user-centered design principles. The DA is a 1-page interactive website presenting and comparing medications for tobacco cessation and electronic cigarettes. Each smoking cessation medication has a drop down menu that presents additional information, a video demonstration, and prescribing information for physicians. To test the DA, we submitted a questionnaire to approximately 20 general practitioner residents of an academic general medicine department, 5 general practitioners, and 6 experts in the field of smoking cessation. The questionnaire consisted of 4 multiple-choice and 2 free-text questions assessing the usability or acceptability of the DA, the acquisition of new knowledge for practitioners, the perceived utility in supporting shared decision-making, perceived strengths and weaknesses, and whether the participants would recommend the tool to other clinicians.
Results: In all, 6 residents, 3 general practitioners in private practice, and 2 tobacco cessation experts completed the questionnaire (N=11), with 4 additional experts providing open-text feedback. On the 11 questionnaires, the DA was rated as practical and intuitive (mean 4.6/5), and providers felt it supported shared decision-making (mean 4.4/5), as comparisons were readily possible. Inclusion of explanatory videos was seen as a bonus. Several changes were suggested, like grouping together similar medications and adding a landing page to briefly explain the site. Changes were implemented according to end-user comments.
Conclusions: The overall assessment of the encounter DA by a group of physicians and experts was positive. The ultimate objective is to have the tool deployed and easily accessible for all to use.
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http://dx.doi.org/10.2196/32960 | DOI Listing |
Tob Control
January 2025
University of California San Francisco, San Francisco, California, USA.
Background: Hookah tobacco smoking is prevalent among youth and young adults. While health warning labels play a critical role in communicating the health risks of tobacco product use to consumers, compliance with US Federal Regulation's nicotine warning requirements on hookah tobacco packaging is low. Some labelling suggests that consumers are exposed to 'only 0.
View Article and Find Full Text PDFLancet
January 2025
Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum, Germany.
Axial spondyloarthritis manifests as a chronic inflammatory disease primarily affecting the sacroiliac joints and spine. Although chronic back pain and spinal stiffness are typical initial symptoms, peripheral (ie, enthesitis, arthritis, and dactylitis) and extra-musculoskeletal (ie, uveitis, inflammatory bowel disease, and psoriasis) manifestations are also common. Timely and accurate diagnosis is challenging and relies on identifying a clinical pattern with a combination of clinical, laboratory (HLA-B27 positivity), and imaging findings (eg, structural damage on pelvic radiographs and bone marrow oedema on MRI of the sacroiliac joints).
View Article and Find Full Text PDFJ Clin Med
January 2025
Faculty of Medicine, "Carol-Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.
: Bupropion, an atypical antidepressant and smoking cessation aid, is known for its potential to cause seizures, cardiotoxicity and neurotoxicity in overdose scenarios. However, overdoses may present variably, and muscular and renal complications, such as rhabdomyolysis and acute kidney injury (AKI), can emerge in unexpected ways. Previous reports have shown that severe overdoses can lead to a spectrum of complications, but the precise mechanisms linking bupropion overdose with rhabdomyolysis remain poorly understood.
View Article and Find Full Text PDFPerioper Med (Lond)
January 2025
Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK.
Background: Smoking is the leading single cause of preventable death in England and also increases the risk of postoperative complications. The preoperative period is a potential opportunity to introduce smoking cessation interventions to smokers to reduce the risk of postoperative complications. A systematic search was conducted to find all studies that investigated the effectiveness of preoperative smoking cessation interventions.
View Article and Find Full Text PDFEncephale
January 2025
Dijon University Hospital, BP77908, Bâtiment Marion, 14, rue Paul Gaffarel, 21079 Dijon cedex, France; Inserm U1093, CAPS, Université de Bourgogne, UFR STAPS, BP 27877, F-21078 Dijon, France.
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