Motivating smokers with mental illness to quit found to be more effective than educational intervention

Significantly more individuals who smoke that have a mental illness made an attempt to quit after receiving a single 45-minute counseling session compared to those who received an interactive educational intervention. The researchers randomized 98 smokers with serious mental illness to receive either the counseling session or the interactive educational intervention. They found that a significantly greater portion of the patients who received motivational interviewing made an attempt to quit by the 1-month follow-up. The findings suggest that motivational interviewing may be the key to having people with mental illnesses quit smoking.

The researchers say that people who have mental illnesses are less likely to quit compared to those who don’t. Therefore, using motivational interviewing might be the most effective way to get these patients to quit smoking.

I think this article is interesting because it shows the effectiveness of motivational interviewing that we learned about in Community Health 2. Since people told us it is useful, it was cool to find a study that actually showed its effectiveness. Moreover, I think it is also interesting that researchers are trying to determine the best ways to motivate people to see which methods are most effective. My question for the class is: How do you think pharmacists can implement motivational interviewing into their practice?

Reference:

Marc L. Steinberg, Jill M. Williams, Naomi F. Stahl, Patricia Dooley Budsock, Nina A. Cooperman. An Adaptation of Motivational Interviewing Increases Quit Attempts in Smokers With Serious Mental IllnessNicotine & Tobacco Research, 2016; 18 (3): 243 DOI:10.1093/ntr/ntv043

The Unreasonable Patient

Is it okay to at some point place the blame on the patient and label them unreasonable? If you have the same patient constantly coming into your pharmacy and never reaching their goals but are obviously non-adherent can you the pharmacist blame that patient.  In this very interesting article Dr. Thurston a MD, from the University of Pittsburgh Medical Center, dives into this issue. Although this article is from the perspective of a palliative care doctor I believe it has some great teaching points for people in all medical professions.

Dr. Thurston uses a personal story about a man who was labeled unreasonable to get his point across. This particular patient had been admitted many times in one year and had an incurable cancer however he keep going through very invasive and dangerous procedures. The other health care professional labeled him as unreasonable because he kept going through with them but what they didn’t do is really talk to the patient. When Dr. Thurston met with the patient he talked to him and asked the right questions. He utilized good listening skills and empathized with the man. By doing this he was able to find out that this patient wanted people to tell him the truth and shoot it to him straight. The man explained the doctors said his cancer was bad but they always gave him an option to try another round of chemo and so he thought that meant there was a chance for him to cure his cancer. Once Dr. Thurston knew this he told the man the tough truth in a very blunt manner. He told him that he was going to die and the cancer is incurable. After that the man made the decision to go home and die at home. The man also expressed his gratitude to Dr. Thurston for being very honest and blunt with him because he was finally able to make a realistic decision.

When dealing with patients it is very important to listen and be very observant. You have to ask the right questions and show empathy. No one person is alike and for that reason you have to address everyone differently. It is very easy to blame someone else but when you’re a health care provider it is important to look inside and see what you can do differently to help the patient and get them to their goals. I thought this was a great lesson for future pharmacist and very important for us when we begin to council patients.

Thurston A. The unreasonable patient. JAMA. 2016;315(7):657-658

JAMA. 2016;315(7):657-658