- Title
- What components of smoking cessation care during pregnancy are implemented by health providers? A systematic review and meta-analysis
- Creator
- Gould, Gillian Sandra; Twyman, Laura; Stevenson, Leah; Gribbin, Gabrielle R.; Bonevski, Billie; Palazzi, Kerrin; Bar Zeev, Yael
- Relation
- BMJ Open Vol. 9, Issue 8, no. e026037
- Publisher Link
- http://dx.doi.org/10.1136/bmjopen-2018-026037
- Publisher
- BMJ
- Resource Type
- journal article
- Date
- 2019
- Description
- Background: Pregnancy is an opportunity for health providers to support women to stop smoking. Objectives: Identify the pooled prevalence for health providers in providing components of smoking cessation care to women who smoke during pregnancy. Design: A systematic review synthesising original articles that reported on (1) prevalence of health providers' performing the 5As ('Ask', ' Advise', ' Assess', ' Assist', ' Arrange'), prescribing nicotine replacement therapy (NRT) and (2) factors associated with smoking cessation care. Data sources: MEDLINE, EMBASE, CINAHL and PsycINFO databases searched using ' smoking', ' pregnancy' and ' health provider practices'. Eligibility criteria for selecting studies: Studies included any design except interventions (self-report, audit, observed consultations and women's reports), in English, with no date restriction, up to June 2017. Participants: Health providers of any profession. Data extraction, appraisal and analysis: Data were extracted, then appraised with the Hawker tool. Meta-analyses pooled percentages for performing each of the 5As and prescribing NRT, using, for example, ' often/always' and ' always/all'. Meta-regressions were performed of 5As for ' often/always'. Results: Of 3933 papers, 54 were included (n=29 225 participants): 33 for meta-analysis. Health providers included general practitioners, obstetricians, midwives and others from 10 countries. Pooled percentages of studies reporting practices ' often/always' were: ' Ask' (n=9) 91.6% (95% CI 88.2% to 95%); 'Advise' (n=7) 90% (95% CI 72.5% to 99.3%), ' Assess' (n=3) 79.2% (95% CI 76.5% to 81.8%), ' Assist (cessation support)' (n=5) 59.1% (95% CI 56% to 62.2%), ' Arrange (referral)' (n=6) 33.3% (95% CI 20.4% to 46.2%) and ' prescribing NRT' (n=6) 25.4% (95% CI 12.8% to 38%). Heterogeneity (I 2) was 95.9%-99.1%. Meta-regressions for ' Arrange' were significant for year (p=0.013) and country (p=0.037). Conclusions: Health providers ' Ask', ' Advise' and ' Assess' most pregnant women about smoking. 'Assist', ' Arrange' and ' prescribing NRT' are reported at lower rates: Strategies to improve these should be considered.
- Subject
- smoking cessation; pregnancy; health professionals; nicotine replacement therapy
- Identifier
- http://hdl.handle.net/1959.13/1411713
- Identifier
- uon:36376
- Identifier
- ISSN:2044-6055
- Rights
- © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
- Language
- eng
- Full Text
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