The 13th World Conference on Tobacco OR Health

Objective: Investigate the effectiveness of a multi-faceted practice support program (based on evidence from organisational change and implementation literature) to implement the 5As as a standard operating procedure for smoking cessation in community pharmacy.

Methods: A randomised controlled trial methodology was used involving 81 community pharmacies in South Australia. Over 400 pharmacy staff completed baseline measures including self-reported activity, knowledge, confidence and barriers. Following randomisation, 41 intervention pharmacies undertook the support program including; workshop, academic detailing, mystery shopping and staff meetings. Baseline measures were repeated at study completion and outcome indicators such as faxed referrals to Quitline were recorded.

Results: Intervention pharmacies outperformed the control group on the majority of measures associated with application of the 5As. Eighteen intervention pharmacies (49%) referred 107 smokers into support programs. Control group pharmacies did not refer any smokers to comparable support programs. Intervention staff reported significantly higher levels of confidence (M = 3.2, SD = .83 vs control group M = 3.0, SD = .82, p < .05) and knowledge (M = 3.3, SD = .81 vs control group M = 3.0, SD = .82, p < .05) post intervention. However, a number of system and practitioner barriers remained of high importance including time and financial incentives.A systematic, evidence based approach to implementation has demonstrated significant practice change. Remaining barriers demonstrate a need for ongoing support at the practice and policy level.