An integral Pro Active Multicomponent Approach (PAMA) to optimize and tailor smoking cessation strategies for the primary health care (PHC) setting

    Ph.D researcher:  Daniëlle Zijlstra MSc.

    Supervisor: Dr. Ciska Hoving

    Co-researchers: Dr. Catherine Bolman, Prof. Dr. Jean Muris & Prof. Dr. Hein de Vries

    Funding: ZonMW

    Objective: This project aims to develop a Pro Active Multicomponent Approach (PAMA) to optimize and tailor smoking cessation treatment for smokers in primary care. PAMA aims at increasing commitment of patients with smoking related complaints to self-chosen smoking cessation methods with the aid of the GP and PN. Reaching smokers will be enhanced by involving pharmacies, and by asking EBI providers to proactively approach smokers once a choice for a particular EBI has been made.


    STUDY 1 will make an inventory of the current and desired practice of smoking cessation counseling in the primary health care setting to assess:

    1. Which strategies are currently used;
    2. What characterizes the practices that are successfully implementing smoking cessation counseling to patients (in terms of reach of smokers, performance of 5As, use of evidence based EBIs, etc.);
    3. What the facilitating and hindering factors are for smoking cessation counseling in the GP setting and for adequate referral to other EBIs in primary care.
    4. How to best develop an implementation guideline outlining to implement PAMA nationally.

    STUDY 2 Delphi Study -aims to study levels of consensus concerning:

    1. The criteria to define evidence based methods to be used in the GP setting;
    2. The methods to be included in the four domains of approaches (counseling; eHealth; telephonic counseling; group counseling) and how to discuss e-cigarettes;
    3.  The support needed for GPs, PNs and pharmacist (assistants) for PAMA;
    4.  The training and methods need to optimally equipped GPs and PNs concerning the improvement of delivery of the 5A method and the application of the shared decision making protocol for their smoking patients.

    STUDY 3 concerns an effectiveness study with the goal to assess program appreciation, level of informed decision making and smoking cessation. It is a randomized controlled study with assessments at baseline and after 6 and 12 months.

    STUDY 4 will determine the cost-effectiveness of the PAMA protocol using a time horizon of 12 months. The cost-effectiveness ratio will be stated in terms of costs per outcome rate, the cost-utility ratio will focus on the net cost per QALY gained.

    Study 5 will 1. Assess reactions of GPs, PNs, Pharmacists and other stakeholders concerning PAMA; 2. To explore the determinants of future adoption of this protocol by their practice.

    Finally, an implementation guideline will be developed with the advisory board to outline national PAMA implementation.

    Results: No results are available yet.

    Publications: No publications are available yet.

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