MS-CHAT: Counseling from trained medical students may help patients quit smoking
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LOUISVILLE, Ky. — Trained medical students may be able to provide effective tobacco cessation counseling to hospitalized patients, thereby improving patient access to counseling services, a speaker reported.
Researchers also observed improvements in student knowledge of behavioral counselling, according to the results of the MS-CHAT trial.
Priyanka Satish, MD, cardiology fellow at Houston Methodist DeBakey Heart and Vascular Center, received the second place in early career research award at the American Society for Preventive Cardiology Congress on CVD Prevention for evaluating whether counseling from trained medical students for hospitalized patients who self-report smoking could increase patient quit rates and improve medical student knowledge of behavioral counseling.
“This is a feasible and effective intervention, and it provides experiential training for a very important skill. Students need experiential training for performing lifestyle counseling and this is a skill they're going to take forward,” Satish said during the presentation. “It has the added advantage of providing increased patient access to counseling services that is scalable across different health care systems.
“We conducted this as a pilot at Case Western Reserve University/University Hospitals Cleveland Medical Center when I was a resident, and it had a great uptake among the first-year students. In fact, the next batch of students wanted it to continue as an elective,” Satish said.
MS-CHAT was a randomized controlled trial conducted at three centers in India with University Hospitals Cleveland Medical Center as the coordinating site.
During a single 30-minute counseling session, a total of 84 second or third-year medical students provided motivational interviewing and discussed pharmacotherapy for smoking cessation with hospitalized patients.
A total of 688 patients were randomly assigned to counseling or standard care. Approximately half of hospitalized patients were admitted with a cardiorespiratory diagnosis, while the remainder of hospitalizations were either gastrointestinal/liver, infection or cancer related.
Additionally, the students followed up with their respective patients with three to five phone calls in the 2 months post-discharge.
Patients were subsequently followed up but a study coordinator via phone call at 2 and 6 months.
The primary outcome was self-reported 7-day rate of smoking cessation at 6 months.
At 6 months, 54.8% of patients who received counseling reported 7-day smoking cessation compared with 42% in the control arm, translating to an absolute difference of 12.8% (RR = 1.67; 95% CI, 1.23-2.26; P < .001).
At 12 months, the medical students were then assessed with a post training knowledge test from a proctor experienced in tobacco cessation counseling and student education.
Researchers observed an increase in student knowledge score from 14.8 at baseline to 18.1 at 12 months, where the highest possible score was 25 (P < .001).
“My students were really encouraged by their ability to get their patients to quit," Satish said. "We questioned the validity of the self-report and in the few patients that we did biochemical [smoking cessation] verification, we saw a good correlation between self-report and biochemical verification. This has been reported in prior studies.”
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Satish P. Early Career Research Rapid Fire Presentations. Presented at: American Society for Preventive Cardiology Congress on CVD Prevention; July 29-31, 2022; Louisville, Kentucky.
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