Assessing NHS stop smoking service engagement in community pharmacies using actors

Problem

Smokers are four times more likely to quit if they use NHS Stop Smoking Services (SSS). However, community pharmacies commissioned to provide smoking cessation services experience low smoker uptake, perhaps due to low staff confidence and limited training. Moreover, lack of smoker registration and monitoring within community pharmacies makes it challenging to assess staff performance when providing NHS SSS. The Smoking Treatment Optimisation in Pharmacies (STOP) programme will address these problems by developing an enhanced staff training programme focused on improving pharmacy staff's ability to engage smokers onto the NHS SSS. Aim - to assess impact of STOP training on pharmacy staff’s ability to engage smokers using simulated clients in a limited pilot study.

Approach

Pharmacy staff from 6 local community pharmacies were approached about taking part in the STOP pilot study. Staff who provided informed consent subsequently attended and completed the STOP training.To assess impact of STOP training on staff's ability to engage clients onto NHS SSS, six actors from ethnically diverse backgrounds representative of the East London population, were recruited and trained to complete intervention fidelity assessments. Two weeks after pharmacy staff completed STOP training, the actors visited the pharmacies, posing as clients eligible for smoking cessation support. Fidelity was assessed using a scoring tool designed for the STOP study (scoring range of 0-36). Staff were unaware of actors' visits.

Findings

21 out of 32 pharmacy staff from 6 pharmacies agreed to take part in the STOP pilot study and training. One pharmacist from one pharmacy withdrew due to an unforeseen family emergency. Therefore 20 staff subsequently attended and completed the STOP training. Actors completed 30 fidelity assessments, 18 of these with STOP trained staff. 10 of these 18 staff were counter assistants. Overall, STOP trained staff scored higher on smoker engagement (24.4 ± 9.0) compared to non-trained staff (16.9 ± 7.8).

Consequences

STOP training may improve community pharmacies’ engagement of smokers onto NHS SSS. Assessing performance in community pharmacy settings using simulated clients is feasible and may provide useful indicators of an intervention’s potential impact.