Implementing the ask-advice-connect method in a university hospital

Abstract Funding Acknowledgements Type of funding sources: None. Background Smoking cessation reduces the relative risk of morbidity and mortality.(1, 2) Healthcare professionals (HPs) can play a substantial role in smoking cessation counselling (SCC) but in practice often skip this task.(3, 4) A quick and effective method for HPs to assist is the Ask-Advise-Connect method in which the physician asks about smoking, advises to quit and offers to connect the patient to an external SCC program.(5) Purpose To evaluate an intervention aimed to implement the Ask-Advise-Connect (AAC) method in a University hospital. Methods This mixed methods pre-post interventional study was performed at the Cardiology department of a University hospital and consisted of 1) semi-structured interviews with 10 HPs to assess their attitudes towards AAC, 2) a blended intervention aimed to implement AAC, and 3) quantitative assessment of patient smoking registration and HP connection rates to external SCC which were collected from the Electronic Medical Record. In total, 48,321 patient consultations and 67 HPs were included. The blended intervention consisted of face-to-face and online AAC psychoeducation for HPs followed-up with motivational messages over a period of 6 weeks. Results Before the intervention, HPs assessed smoking status in 74.0% of patients and connected 9.3% of identified smokers with external SCC. The blended intervention did not increase these percentages at post-test (respectively 73.2%, p=0.20; and 10.9%, p>0,05). Nonetheless, the vast majority of HPs feel it is important to discuss patient smoking, and view it as their duty to do so. Main barriers to AAC reported by HPs were forgetfulness and time pressure. Conclusion This study shows that this AAC intervention does not increase Asking after smoking status or Connection of patients to SCC. However, HPs hold positive attitudes towards AAC. A better understanding of the mechanisms required for changing HPs practice behavior is needed.