Pacific University Dental Hygiene Studies Nicotine Cessation 2019

Pacific University Dental Hygiene Studies Nicotine Cessation 2019 -20 By: Darsha Van Antwerp, Michael La. Rocco, Riley Plank

Purpose ● Calibrate all DHS students, faculty, and staff on Pacific University’s updated nicotine cessation protocol ● Provide patients of the DHS clinic with brief evidence-based nicotine cessation counseling and referrals for further treatment

Background Research ● ● ● 5 A’s: Ask, Advise, Assess, Assist, Arrange ○ Purpose: table is used for decision-making during brief counseling interventions Prescriptions to help ○ In combination with nicotine cessation counseling, it increases a patient's ability to quit (ie. Welbutrin and Chantix) Perceptions practice ○ 53% of dental hygienists were either not at all or somewhat comfortable in helping patients develop a tobacco cessation plan

Needs Assessment ● Target population: patients who use nicotine ● We want to encourage users to decrease nicotine use and eventually quit with the help of clinicians to motivate them to do so ● Tools: chairside guides & packets for patients ● Referrals: ○ Physician for further follow-up and possible medications Knowledge about resources seemed inconsistent among students and faculty members. Calibration for consistency was needed.

Plan ● ● ● Update Clinic Tobacco Cessation Protocol Update Clinic Cessation Packets Create Chairside Guides Make changes to Axi. Um Create CE Calibration Presentation for faculty

Implementation ● ● Facilitated calibration training session regarding nicotine cessation protocol at Pacific University ○ 4/9/20 - presented to all faculty (30 -40 faculty members) ○ Presented on group Zoom Changes will be put into effect by Fall Term 2020 ○ Changes to Axi. Um ○ Packets (English and Spanish) will be printed and placed above clinic computers ○ Chairside guides will be printed, laminated and placed in clinic drawers ○ CE course will be distributed to Brandy Cowen for future education

Cessation Packets and Chairside Guides ● ● Location of packets: ○ In a labeled box above clinic computers. Timing: ○ Best time to utilize the packets is when patient has expressed a desire to quit smoking, help patient develop quit date. Updates to clinic protocol and how to use as a brief counseling tool: https: //docs. google. com/document/d/1 ZKWsn 6 Ohm. IMwgl. GYAE 9 f 1 u. Vh_53 Xe. Bi 2 b. Tmw. Pd. QNGw/edit? usp=sharing

Evaluation/Results ● Pre and Post-Survey questions ○ given to faculty members during CE calibration course via Qualtrics. -Pre-Survey: Audience was generally aware of nicotine containing products. Half was able to list 1 -2 prescriptions prior to course. Many listed OTC nicotine replacement therapy instead of Rx medications. 6 out of 21 participants could not list any medications. Participants were generally able to list a variety of resources (CDC, Oregon Quitline, etc. ) -Post-Survey: 13 out of 14 were able to list vaping as a form of nicotine. 13 out of 14 were able to list Chantix and Wellbutrin as Rx medications. Half were able to list CDC Tips from Former Smokers. Many participants listed Vaping information, Axi. Um updates, and review of clinic protocol as helpful. 8 out of 10 respondents said that nothing needed to be improved.

Impact ● Patients - will be receiving nicotine cessation therapy ○ Impact: receiving care that will benefit overall health ● Clinicians/faculty - will be implementing nicotine cessation therapy ○ Impact: will become more knowledgeable in providing nicotine cessation therapy and education

Next steps ● ● Printing and organization of packets and materials in clinic Assign responsibility to maintain ○ Clinic Manager will check amount of packets available on way to prepare radiology rooms ○ If packets are low, Clinic Manager will alert front office to print more ○ Clinicians are responsible for their chairside guides - if one goes missing, alert the front office ○ Axi. Um changes are the responsibility of Allison Santoro ○ Clinic Faculty are responsible for seeing if clinician has made proper referrals and chart notes regarding pt nicotine cessation therapy

References 1. Barua, R. S. , Rigotti, N. A. , Benowitz, N. L. , Cummings, K. M. , Jazayeri, M. A. , Morris, P. B. , & Wiggins, B. S. (2018). Expert Consensus Decision Pathway on Tobacco Cessation Treatment: A Report of the American College of Cardiology Task Force on Clinical Expert Consensus Documents. Journal of the American College of Cardiology, 72(25), 3332– 3365. Retrieved from https: //doi. org/10. 1016/j. jacc. 2018. 10. 027 2. Clinical Practice Guideline Treating Tobacco Use and Dependence Update Panel, Liaisons, and Staff : 2008 update. A U. S. Public Health Service report. (2008). American Journal of Preventive Medicine, 35(2), 158– 176. Retrieved from doi: 10. 1016/j. amepre. 2008. 04. 009 3. Galanti L. M. (2008). Tobacco smoking cessation management: integrating varenicline in current practice. Vascular health and risk management, 4(4), 837– 845. doi: 10. 2147/vhrm. s 3250. Systematic Review. (Pub. Med) 4. Jamie L. Studts, Jessica L. Burris, Dana K. Kearns, Celeste T. Worth, Connie L. Sorrell. Evidence–based Tobacco Cessation Treatment by Dental Hygienists. . American Dental Hygienists' Association (ADHA) Dec 2011, 85 (1) 13 -21; Systematic review.

References 5. Kachwaha, P. , Singhal, D. K. , & Singh, N. (2019). Perceptions Regarding Tobacco Cessation Counselling among Dental Students and Graduates: A Cross-Sectional Study. Asian Pacific Journal of Cancer Prevention: APJCP, 20(9), 2589– 2593. https: //doi. org/10. 31557/APJCP. 2019. 20. 9. 2589 6. Lexicomp Online, Lexi-Drugs Online, Hudson, Ohio: Wolters Klumer Clinical Drug Information, Inc; Varenicline, March 4, 2020. 7. Lexicomp Online, Lexi-Drugs Online, Hudson, Ohio, Wolters Klumer Clinical Drug Information, Inc; Bupropion, April 14, 2020. 8. (n. d. ). Tobacco and Nicotine Prevention and Control. American Academy of Family Physicians. Retrieved 2020, from https: //www. aafp. org/patient-care/public-health/tobacco-nicotine. html 9. The NIDA Blog Team. (2019, February 4). Why Is Nicotine So Addictive? National Institute on Drug Abuse for Teens Retrieved 2020, from https: //teens. drugabuse. gov/blog/post/why-nicotine-so-addictive