Journal article
Health Professionals Performing the “5AS” for Smoking Cessation and Prescribing Nicotine Replacement Therapy During Pregnancy: Meta-Analysis of a Systematic Review
Asia - Pacific Journal of Clinical Oncology, Vol.13(S5), pp.16-16
11/2017
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Abstract
Background: Smoking during pregnancy is the most important remediable risk factor contributing to poor health outcomes for mothers and babies. Health professionals are potentially important providers of smoking cessation care to women during pregnancy.
Aims: Systematically review the literature and identify rates of health providers performing each of the “5As” for smoking cessation and prescribing nicotine replacement therapy (NRT), among pregnant women who smoke.
Methods: Four databases were searched for quantitative studies using terms for tobacco smoking, pregnancy and health providers’ practices. We included self-report, audit, audio-recorded consultations and women's reports. Two researchers independently selected studies; a third adjudicated. One researcher completed data extraction; a second coded 20% of articles. A meta-analysis pooled percentages for performing “Ask,” “Advise,” “Assess,” “Assist” and “Arrange,” and prescribing NRT. Variations in measures for the “5As” resulted in multiple analyses, e.g.: “Ask always/often” and “Ask always/all yes.”
Results: Out of 3933 papers screened, 55 quantitative studies were included: 33 suitable for meta-analysis. Health providers included GPs, Obstetricians, midwives and Aboriginal Health Workers, from 10 countries (seven high-income countries; three low-/mid-income countries). Pooled percentages of studies reporting “always/often” were: “Ask” about smoking (n = 9 papers) 92.7% (95%CI: 86.2, 97.2); “Advise" (n = 7) 90% (CI: 72.5, 99.3), “Assess” (n = 3) 80.6% (CI: 72, 88), “Assist” (n = 5) 58.4% (CI: 51.9, 64.8), “Arrange” (n = 6) 32.8% (CI: 20.6, 46.3) and prescribing NRT 12.6% (CI: 3.2, 26.6). Heterogeneity was high for all measures.
Conclusions: Health providers reliably “Ask,” “Advise” and “Assess” pregnant women about smoking. “Assist,” “Arrange” and providing NRT could be improved by training, and incentives or prompts.
Translational Aspect: Pregnancy is an opportunity for health providers to intervene when women may be motivated to stop smoking. It is important to understand which of the “5As” are more likely to be performed, so that gaps in care can be targeted. This T2 study clarifies which elements of smoking cessation care are well delivered and which are lacking.
Details
- Title
- Health Professionals Performing the “5AS” for Smoking Cessation and Prescribing Nicotine Replacement Therapy During Pregnancy: Meta-Analysis of a Systematic Review
- Creators
- G Gould - University of Newcastle AustraliaY Bar-Zeev - University of Newcastle AustraliaL Stevenson - James Cook UniversityK Palazzi - Hunter Medical Research InstituteB Bonevski - University of Newcastle Australia
- Publication Details
- Asia - Pacific Journal of Clinical Oncology, Vol.13(S5), pp.16-16
- Publisher
- Wiley-Blackwell Publishing Ltd.
- Identifiers
- 991012990798402368
- Copyright
- Editorial material and organization © 2017 John Wiley & Sons Australia, Ltd. Copyright of individual abstracts remains with the authors
- Academic Unit
- Faculty of Health
- Language
- English
- Resource Type
- Journal article