Introduction
Training Program Helps Widen Practitioners' Scope of Practice
According to the American Cancer Society, more than 40 million people in the United States have decided to quit smoking at some point in their lives. That is the good news. The bad news is that more than 400,000 people still die each year from smoking-related causes, and 90% of new smokers are children and teenagers. Clearly, health care practitioners still have plenty of opportunities to help patients by offering cessation programs. Pharmacists can play an integral role in this effort because of their unique access to the public, and the Connecticut Pharmacists Association (CPA) is helping its members get into the act.
Thanks to a special certificate training program, 25 CPA members recently learned to be smoking cessation specialists through a program designed by the University of Pittsburgh School of Pharmacy.
Addressing the Three Aspects
During the 6-hour session, participants learned about the complexities of smoking behavior and how to develop a comprehensive plan to help patients quit. They displayed their acquired skills through role-playing.
Because smoking behaviors are complex, the faculty consisted of a psychologist (Amy Jones-Barlock, PhD, of the University of Pittsburgh School of Health and Rehabilitation Sciences) and a pharmacist (Laurie Trilli, PharmD, of the VA Hospital in Pittsburgh). They addressed three aspects of smoking: physical addiction, habit, and psychological misconceptions.
Participants also reviewed the quitting model: thinking about quitting, quitting, and maintenance, as well as how to address slipping (occasional smoking) and relapsing (returning to routine smoking). Program faculty focused on the role of the pharmacist in the process and the ways in which the pharmacist should react to the patient's needs during each of the stages. Instruction focused on treatment intervention, behavioral and cognitive coping techniques, pharmacotherapy products available, current research data, and role-playing.
Jones-Barlock and Trilli presented their own clinical cases as examples and played a counseling video with role-playing scenes centered on relapsing and craving.
"The group was enthusiastic and participated well in role-playing," Jones-Barlock said. "They had insightful questions about the research and wanted to learn more about this material."
The Role Model Is a Pharmacist
What set this program apart from others was the additional insight of John Parisi, a Connecticut pharmacist who took what he learned from the University of Pittsburgh program 4 years ago and worked it into his expanding pharmaceutical care practice.
During a 1-hour presentation, Parisi, of Ivery and Dudley Pharmacy, Winsted, Conn., explained his small-group program that has helped more than 100 patients. Patients pay $195 to attend eight sessions in Parisi's private counseling room in an attempt to become nonsmokers. Parisi, who has just started a group for teenaged smokers, challenged the pharmacist-attendees to take what they learned and use it for their patients' well-being. He added that he uses the program handouts on a daily basis.
"I thought it was important for pharmacists to see another practitioner doing it," Parisi said. "To have a patient quit smoking is the most fulfilling thing I have ever done as a pharmacist. You know it is the best thing they can do for themselves."
Jones-Barlock called Parisi an "excellent role model" who "reiterated how this program can be used in a community setting. Pharmacists can enhance their business and do something in the areas of cognitive and behavioral therapies," Jones-Barlock said.
Opportune Time for Program
According to CPA Executive Vice President Margherita R. Giuliano, the timing of the program (late March) was excellent for two reasons: In a current collaborative health initiative to develop community outreach programs for patients with diabetes, pharmacists work with these patients and can also counsel them on their smoking habits; and tobacco settlement money has presented the opportunity to encourage tobacco-free pharmacies and smoking cessation programs through state grants.
"Now is a great time to promote not only good health but good pharmacy practice," Giuliano said.
Robert Delaney, of Doanes Pharmacy in Centerbrook, Conn., has conducted some cessation sessions in the past; with the help of the University of Pittsburgh program, he hopes to expand the operation.
"I learned quite a bit more about triggers and the different ways of counseling in different situations," Delaney said. "I expect to see more patients and will talk to people [who are] in the pharmacy buying [nicotine replacement therapy products] and try to get them in the program."
Attendees received 6 continuing education credits after a satisfactory score on the post-session test. After they complete counseling sessions with at least 10 patients within 2 months and report back to the University of Pittsburgh about the interactions, attendees will receive a certificate.
Pharmacy Today. 2000;6(5) © 2000 American Pharmacists Association
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Cite this: Connecticut Pharmacists Learn to Become Smoking Cessation Specialists - Medscape - May 01, 2000.
