Implementing tobacco dependence treatment during clinical consultations : a qualitative study of clinicians’ experiences, perceptions and behaviours in a South African primary health care setting

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dc.contributor.author Omole, Olufemi B.
dc.contributor.author Ayo-Yusuf, Olalekan A.
dc.contributor.author Ngobale, Kabilabe N.W.
dc.date.accessioned 2014-09-09T06:18:56Z
dc.date.available 2014-09-09T06:18:56Z
dc.date.issued 2014-05-06
dc.description.abstract BACKGROUND : Evidence suggests that healthcare providers (HCPs) in South Africa do not consistently offer tobacco dependence treatment (TDT) during clinical consultations. In order to understand and explain this behaviour in a South African context, we conducted a qualitative exploration of HCPs’ experiences, perceptions and behaviours regarding TDT. METHODS : Individual qualitative interviews were conducted with physicians and nurses who were purposively selected. Themes were identified from interview transcripts using content analysis. Findings were triangulated and peer-reviewed, and were also verified by the participants. RESULTS : Fifteen physicians and four nurses were interviewed, none of whom used tobacco. These participants perceived TDT as an important task, but could not consistently implement it during clinical consultations due to health systems constraints (time-constraints because of patient-overload, the unavailability of cessation medications and a lack of support for referrals), misperceptions and misconceptions (negative outcome expectations about the effectiveness and feasibility of TDT), socio-cultural barriers (counselling older persons was perceived as challenging) and personal limitations (perceived low self-efficacy, poor knowledge and skills on implementing any evidence-based TDT framework). Patients are therefore selectively screened based on clinical relevance and offered only prescriptive brief advice. Participants recommended several systems changes, including academic detailing of tobacco status, training HCPs and incorporating tobacco cessation medications in the Essential Drug List. CONCLUSION : The reported selective screening and limited TDT interventions offered by HCPs are related to interactions between health systems constraints, personal limitations, and misperceptions and misconceptions about the effectiveness and feasibility of TDT during clinical consultation. Implementing the recommended systems changes has the potential to improve the implementation of TDT in South African primary health care (PHC). en_US
dc.description.librarian am2014 en_US
dc.description.sponsorship This report is support by grant to OAA from the South African National Research Foundation (Grant # 80843). en_US
dc.description.uri http://www.biomedcentral.com/bmcfampract/ en_US
dc.identifier.citation Omole, OB, Ayo-Yusuf, OA & Ngobale, KNW 2014, 'Implementing tobacco dependence treatment during clinical consultations: a qualitative study of clinicians’ experiences, perceptions and behaviours in a South African primary health care setting', BMC Family Practice, vol. 15, art. 85, pp. 1-10. en_US
dc.identifier.issn 1471-2296
dc.identifier.other 10.1186/1471-2296-15-85
dc.identifier.uri http://hdl.handle.net/2263/41948
dc.language.iso en en_US
dc.publisher BioMed Central en_US
dc.rights © 2014 Omole et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License. en_US
dc.subject Behaviours en_US
dc.subject Primary care en_US
dc.subject Healthcare providers (HCPs) en_US
dc.subject Tobacco dependence treatment (TDT) en_US
dc.subject South African primary health care en_US
dc.title Implementing tobacco dependence treatment during clinical consultations : a qualitative study of clinicians’ experiences, perceptions and behaviours in a South African primary health care setting en_US
dc.type Article en_US


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