Files and links (2)
Published (Version of record)CC BY-NC V4.0, Open Access
Published (Version of record)CC BY-NC V4.0, Open
Journal article
What components of smoking cessation care during pregnancy are implemented by health providers? A systematic review and meta-analysis
BMJ Open, Vol.9(8), pp.1-13
18/08/2019
PMCID: PMC6701616
PMID: 31427313
Metrics
9 Record Views
UN Sustainable Development Goals (SDGs)
This output has contributed to the advancement of the following goals:
Source: InCites
Abstract
Background Pregnancy is an opportunity for health providers to support women to stop smoking.
Objectives Identify the pooled prevalence for health providers in providing components of smoking cessation care to women who smoke during pregnancy.
Design A systematic review synthesising original articles that reported on (1) prevalence of health providers’ performing the 5As (‘Ask’, ‘Advise’, ‘Assess’, ‘Assist’, ‘Arrange’), prescribing nicotine replacement therapy (NRT) and (2) factors associated with smoking cessation care.
Data sources MEDLINE, EMBASE, CINAHL and PsycINFO databases searched using ‘smoking’, ‘pregnancy’ and ‘health provider practices’.
Eligibility criteria for selecting studies Studies included any design except interventions (self-report, audit, observed consultations and women’s reports), in English, with no date restriction, up to June 2017.
Participants Health providers of any profession.
Data extraction, appraisal and analysis Data were extracted, then appraised with the Hawker tool. Meta-analyses pooled percentages for performing each of the 5As and prescribing NRT, using, for example, ‘often/always’ and ‘always/all’. Meta-regressions were performed of 5As for ‘often/always’.
Results Of 3933 papers, 54 were included (n=29 225 participants): 33 for meta-analysis. Health providers included general practitioners, obstetricians, midwives and others from 10 countries. Pooled percentages of studies reporting practices ‘often/always’ were: ‘Ask’ (n=9) 91.6% (95% CI 88.2% to 95%); ‘Advise’ (n=7) 90% (95% CI 72.5% to 99.3%), ‘Assess’ (n=3) 79.2% (95% CI 76.5% to 81.8%), ‘Assist (cessation support)’ (n=5) 59.1% (95% CI 56% to 62.2%), ‘Arrange (referral)’ (n=6) 33.3% (95% CI 20.4% to 46.2%) and ‘prescribing NRT’ (n=6) 25.4% (95% CI 12.8% to 38%). Heterogeneity (I2) was 95.9%–99.1%. Meta-regressions for ‘Arrange’ were significant for year (p=0.013) and country (p=0.037).
Conclusions Health providers ‘Ask’, ‘Advise’ and ‘Assess’ most pregnant women about smoking. ‘Assist’, ‘Arrange’ and ‘prescribing NRT’ are reported at lower rates: strategies to improve these should be considered.
PROSPERO registration numberCRD42015029989.
Details
- Title
- What components of smoking cessation care during pregnancy are implemented by health providers? A systematic review and meta-analysis
- Creators
- Gillian Sandra Gould - University of Newcastle AustraliaLaura Twyman - University of Newcastle AustraliaLeah Stevenson - University of Newcastle AustraliaGabrielle R Gribbin - University of Newcastle AustraliaBillie Bonevski - University of Newcastle AustraliaKerrin Palazzi - Hunter Medical Research InstituteYael Bar Zeev - University of Newcastle Australia
- Publication Details
- BMJ Open, Vol.9(8), pp.1-13
- Publisher
- BMJ Group
- Grant note
- This study was funded by a grant from Hunter Cancer Research Alliance, Australia.
- Identifiers
- 991012958198902368
- Copyright
- © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
- Academic Unit
- School of Health and Human Sciences; Faculty of Health
- Language
- English
- Resource Type
- Journal article