2025 Southeastern Residency Conference

Title: Evaluation of the Impact of a Pharmacist-led Smoking Cessation Clinic Within a Primary Care Setting


Authors: Tiffany Gilchrist, Victoria McCarthy, Zil Tyler, Regan Wilson


Objective: To evaluate the effectiveness of a pharmacist-led smoking cessation clinic over a three-year period at the Piedmont Athens Regional Clay Community Care Clinic (CCCC)

Background: Smoking cessation plays a critical role in disease prevention and can significantly improve patient health outcomes. Pharmacists can be a great resource to assist individuals with smoking cessation due to their extensive background in pharmacotherapy and easy accessibility. This retrospective study aimed to evaluate the effectiveness of a pharmacist-led smoking cessation clinic over a three-year period at the Piedmont Athens Regional Clay Community Care Clinic (CCCC). This study hypothesized that patients who establish care with a pharmacist will demonstrate higher quit rates compared to patients who do not establish care with a pharmacist.
  
Methodology: This was a single-center, retrospective chart review of adult patients with a history of cigarette smoking referred to the CCCC pharmacist-led smoking cessation clinic from July 1, 2021 to June 30, 2024. Patients interested in smoking cessation are referred to the pharmacist-led smoking cessation clinic by their primary care provider. However, some patients do not establish care despite pharmacist outreach efforts. The primary outcome of this study is the percentage of patients who successfully quit smoking. Secondary outcomes include the percentage of patients who relapsed after quitting and the percentage of patients who successfully quit after previous unsuccessful quit attempts. Pre-specified subgroup analyses were evaluated for patients who established care with a pharmacist which included time to quit, percentage of patients who adhered to pharmacotherapy if prescribed, percentage reduction of cigarettes smoked from baseline, the percentage of patients who quit after receiving medication and behavioral counseling vs percentage of patients who quit with behavioral counseling alone, and the total number of follow-up visits completed with a pharmacist in patients who quit. Data collected included current cigarette usage at each encounter, pack-year history, pharmacological agents if prescribed, number of follow-up visits, reason for discharge, previous quit attempts, and if patients relapsed after quitting. Continuous data was analyzed using the Mann-Whitney U test and presented as an interquartile range (IQR) or medians. Categorical data was analyzed using the Chi-Square test and presented as percentages or numbers. Statistical significance was met for the primary and secondary outcomes of the study if the p < 0.05. 
  
Results: A total of 171 eligible patient referrals were reviewed, with 150 patients meeting the inclusion criteria. Baseline characteristics were similar between groups, with an average age of 53.5 years and 51.5% male patients. Among the 75 patients who did not establish care with a pharmacist, 67 (89%) did not receive smoking cessation pharmacotherapy. In the intervention group, the most commonly utilized pharmacotherapy was nicotine replacement therapy, prescribed in 54.6% of cases. The primary outcome—patients who quit smoking—was achieved in 14.7% of patients managed through the pharmacist-led smoking cessation clinic, compared to 1.3% of patients who did not establish care (p = 0.003). For secondary endpoints, there was a significant difference in patients who quit smoking after previous unsuccessful quit attempts (13.3% vs. 0%, p = 0.02). No significant difference in patients who relapsed after quitting was found between both groups (5.3% vs. 0%, p = 0.46).
  
Conclusions: In conclusion, patients who established care with a pharmacist had a statistically significant improvement in successful smoking cessation.