Background Despite clinical practice guidelines recommending the routine provision of nicotine dependence treatment to smokers in inpatient psychiatric facilities, the prevalence of such treatment provision is low. Face-to-face staff group training sessions ([14], see Additional file 1) the recorded provision of five elements of nicotine dependence treatment was audited: assessment of smoking status (yes, no); assessment of nicotine dependence (yes, no); provision of brief advice to quit MK-4827 (yes, no); prescription of any form of NRT (including nicotine patch, lozenge, gum, or inhaler) (yes, no), and; provision of nicotine dependence treatment on discharge record (any of: provision of written information/brief advice to quit, offer of referral to Quitline, and provision of NRT post discharge) (yes, no). Analysis Analyses were conducted MK-4827 using SAS version 9.4 software [31]. Admission and discharge dates were used to calculate length of stay. Diagnoses were collapsed into eight most prevalent categories: schizophrenia/psychosis; affective disorders; adjustment/anxiety disorders; substance use disorders; borderline personality disorder; bipolar disorder; dementias, and other mental disorder. For smoking status assessment and provision of brief advice outcomes, audit data from multiple medical record locations were collapsed to form a single measure (recorded/not recorded anywhere). Descriptive statistics were used to summarise patient characteristics, and prevalence of each of the nicotine dependence treatment measures at each of three time periods (pre-intervention, intervention and post-intervention). Chi-square analyses were undertaken to assess differences in patient socio-demographic and clinical characteristics between patients with one or more admission, and between study periods. Similar to other studies of nicotine dependence treatment in hospital settings based on medical record audit [32, 33], each outcome MK-4827 measure is reported as a proportion of the total patient sample (both smokers and non-smokers). Smoking prevalence was assumed to be constant during the study period, based on previous research conducted in this facility [16, 34], and elsewhere [2]. The proportions for each outcome were plotted for each fortnight in the study period [35]. Segmented logistic regression analysis of interrupted time series data was used to determine differences in outcome proportions between the pre- and during, during and post-, and pre to post-intervention periods, to plot outcome proportions across the 19-month study period [36]. Month was the unit of time chosen to generate the slopes in the logistic regression analyses, and as such there were five time points (i.e. months) in the pre-intervention period (1st June to 31st October 2009), nine time points in the intervention period (1st November 2009 to 31st July 2010), and five time points in the post-intervention period (1st August to 31st December 2010). The models adjusted for differences in patient socio-demographic and clinical characteristics (including discharging unit) between study periods. All discharges were treated independently in the analyses. All statistical tests were two-tailed, and the threshold for statistical significance was … Table 3 Results of segmented logistic regression showing differences in odds of reporting of the key nicotine dependence treatment items within, and between the pre- (… The prevalence of recorded assessment of nicotine dependence was stable in the pre-intervention phase, and increased significantly from intervention to post-intervention, with an overall significant increase from pre- to post-intervention (6.30% absolute increase, 99% CI: 3.31 to 9.28; Table?2). As shown in Fig.?1 and Table?3, overall the odds of a nicotine dependence assessment being recorded increased significantly from pre-intervention to the end of the post-intervention period (AOR?=?109.67, 99% CI 35.35, 340.22; Table?3), with increases in odds occurring between each time period (Fig.?1, Table?3). 3. Provision of brief advice to quit The prevalence of recorded brief advice to quit increased significantly between each of the study periods, with an overall significant increase from pre-to post intervention (7.96% absolute increase, 99% CI: 5.62 to 10.30; Table?2). As shown in Fig.?1 and Table?3, the odds of recorded provision Rabbit Polyclonal to OR8J1 of brief advice to quit increased significantly from pre to post-intervention (AOR?=?97.43, 99% CI 31.03, 306.30), with increases in odds occurring between each time period (Table?3). 4. Prescription of NRT The prevalence of recorded prescription of NRT increased significantly between each of the study periods, with an overall significant increase from pre-to post-intervention (18.19% absolute.