Tobacco Cessation Interventions in Non-Respiratory Cancers: A Systematic Review With Meta-analysis of Randomized Controlled Trials.

BACKGROUND: Considering the high rates of persistent tobacco use, effective cessation interventions are needed for cancer patients and caregivers. Despite the need, there is a significant lack of research on tobacco cessation, especially for non-respiratory cancers (breast, prostate, colorectal, cervical, and bladder cancer). PURPOSE: The objective was to evaluate tobacco use and tobacco cessation interventions among patients and caregivers for non-respiratory cancers. METHODS: Randomized controlled trials assessing tobacco cessation interventions were identified. Five electronic databases were searched in accordance with the Preferred Reporting Items for Systematic reviews and Meta-analyses guidelines through July 2023. Studies exclusive to lung, oral, thoracic, and head and neck cancers were excluded. Effect sizes were estimated; risk of bias was assessed. RESULTS: Of 3,304 studies, 17 were included. Interventions included behavioral (n = 6), pharmacotherapy (n = 2), and a combination (n = 9) treatment. Eight studies included a health behavior model; mean behavioral change techniques were 5.57. Pooled magnitude of the odds of cessation was positive and significant (odds ratio = 1.24, 95% confidence interval [Lower Limit 1.02, Upper Limit 1.51]) relative to usual care/placebo. Cumulative meta-analysis examined the accumulation of results over-time and demonstrated that studies have been significant since 2020. Two studies included caregivers' who were involved in the provision of social support. CONCLUSIONS: Current interventions have the potential to reduce tobacco use in non-respiratory cancers. Results may be beneficial for promoting tobacco cessation among non-respiratory cancers. There is a considerable lack of dyadic interventions for cancer survivors and caregivers; researchers are encouraged to explore dyadic approaches.

We aimed to understand effective ways for cancer patients and caregivers to quit using tobacco. We focused on non-respiratory cancers (cancers not related to breathing issues) like breast, prostate, and colorectal cancer. We reviewed 17 randomized controlled trials designed to help people quit tobacco, which included behavioral therapies (e.g., education and counseling), pharmacotherapy (i.e., medicine), and combinations of both. We found that people in these studies quit using tobacco, especially when more than one approach was used. The studies also showed that these approaches have been more successful since 2020. The research highlighted a need for more studies that include both patients and their caregivers together in the quitting process. This approach, called dyadic intervention, could be more effective in supporting patients and their caregivers. Overall, while the current approaches are promising, more research is needed to develop better ways to help cancer patients and caregivers quit smoking for longer.

Interacting within an asynchronous online interprofessional education workshop focused on social determinants of health.

BACKGROUND: Meaningful interprofessional education (IPE) involves students from at least two professions interacting to learn with, about, and from one another. Our objective was to describe a novel online approach used to create meaningful IPE within a social determinants of health (SDoH) workshop. INTERPROFESSIONAL EDUCATION ACTIVITY: This online workshop integrated four different professions' perspectives on SDoH (social-work, public-health, nursing, and pharmacy). Each six-student interprofessional team was assigned a local neighborhood. This week-long workshop had numerous activities (pre- and post-workshop quizzes, a SDoH-primer video, video self-introduction to teammates, a windshield questionnaire with two subsequent clinical cases, a post-workshop reflection, and post-workshop evaluation). For discussion, asynchronous video-based responses were used instead of traditional text-based discussion-boards. DISCUSSION: Quantitatively comparing quiz scores, students' SDoH knowledge increased with this workshop. Qualitatively from evaluations, most students found this workshop helpful and meaningful. Supporting use of video-based responses, many students' favorite aspect was interacting and collaborating within their interprofessional teams, although some students desired synchronous activities instead. Faculty facilitators confirmed that meaningful IPE interactions occurred. IMPLICATIONS: In short, students from multiple health-professions learned SDoH-content and, using video-based responses, interacted asynchronously during this online workshop. This report demonstrated one tool available to help facilitate meaningful IPE asynchronously. This asynchronous, online IPE workshop appears to be a promising format to be integrated with other in-person IPE sessions.

Opioid-related polysubstance use and its effect on mortality and health resource utilization among trauma patients.

BACKGROUND: Pre-injury opioid use is common, but the effects of opioid-related polysubstance use on mortality and health resources utilization (HRU) have not been investigated yet. The objective of this study was to investigate the effects of opioid-related polysubstance use on mortality and HRU among patients in trauma centres in the US. METHODS: We conducted a retrospective cross-sectional study using the US National Trauma Databank from the year 2017 to 2019. Patients (≥ 18 years of age) who tested positive for opioids were included. Patients were analysed based on the number of substances used (i.e., opioids only, two substances (opioids + 1 substance), and three or more than three substances (opioids + ≥ 2 substances)), and polysubstance by type (i.e., opioids only, opioids and alcohol, opioids and stimulants, opioids and benzodiazepine, and other combinations). Multivariate logistic regression was used to determine the association between polysubstance use, mortality and HRU (i.e., need for hospital admission, ICU, and mechanical ventilation). RESULTS: Both polysubstance by number and type analyses showed that opioid-related polysubstance use was not significantly associated with mortality compared to opioids only. The odds of hospital admission were higher among the opioids and benzodiazepines group (OR 1.15, 95% CI 1.06-1.24, p < 0.01). The need for ICU was magnified using benzodiazepines and stimulants with opioids (OR 1.44, 95% CI 1.27-1.63, p < 0.01) when compared to the opioids only group. CONCLUSION: Opioid-related pre-injury polysubstance use was associated with higher HRU in trauma patients. The evidence can be used by policymakers and practitioners to improve patient outcomes in trauma centers.

Comparing Data Submitted by Public and Private Pharmacy Schools to the Opioid-Related Activities Database.

Objective. This investigation compared similarities and differences in education on opioids and opioid abuse between public and private US schools and colleges of pharmacy.Methods. The American Association of Colleges of Pharmacy has created and maintains an Opioid-Related Activities database for schools and colleges of pharmacy in the United States. With data from 2019, a mixed-methods design was used to triangulate quantitative analysis with a concurrent qualitative analysis. After describing, the data were compared to national statistics of schools and colleges of pharmacy (ie, number, type of school, and program structure). Data from the database on opioid activity types (ie, education, service, practice, research, and advocacy) were compared between private and public institutions, both quantitatively and qualitatively. The quantitative analysis used odds-ratios (for effect-size) and chi-square (for statistical significance), while the qualitative analysis employed word clouds to explore opioid-related activities descriptors.Results. One-hundred-seven of 144 US schools and colleges of pharmacy (74% response rate) provided their opioid-related activities information to AACP. The institutions (55 private, 52 public) had entered 436 unique opioid-related activities in the AACP database. Results of the quantitative and qualitative analyses triangulated that private institutions focused more on education-opioid-related activities, while public institutions offered more activities that involving research. Magnified to education-type opioid-related activities, faculty from private institutions often focused narrowly on an education event alone, while faculty from institutions often focused more broadly on education and other aspects such as funding, research and published articles.Conclusion. Overall, private and public US schools and colleges of pharmacy widely engaged in combatting the US opioid epidemic by training student pharmacists in this important area.