NURS FPX 4025 Assessment 3

Student Name

Capella University

NURS-FPX4025 Research and Evidence-Based Decision Making

Prof. Name

Date

Assessment 3: Smoking Cessation Programs for COPD Patients

Chronic Obstructive Pulmonary Disease (COPD) is a debilitating lung condition that significantly impairs breathing, and its progression is exacerbated by smoking. While smoking plays a key role in worsening COPD, quitting smoking presents a major challenge for many individuals. COPD remains one of the leading causes of death in the United States, affecting around 16 million adults (Centers for Disease Control and Prevention [CDC], 2024). Quitting smoking can slow disease progression and improve overall health, but patients face various barriers such as nicotine addiction, stress, and a lack of support, making cessation difficult. This assessment compares the effectiveness of structured smoking cessation programs and standard counseling in helping COPD patients quit smoking, with the objective of determining which method is more effective in promoting cessation and improving lung health over a six-month period.

Explaining the Diagnosis

COPD is a progressive lung disease marked by chronic symptoms like coughing, shortness of breath, and frequent respiratory infections. If left untreated, the disease can worsen, leading to frequent hospitalizations, heart issues, and respiratory failure. The most effective strategy to slow the progression of COPD is smoking cessation; however, many patients find it difficult to quit due to nicotine addiction, stress, and insufficient support (American Lung Association [ALA], 2024). Certain groups, such as older adults, low-income individuals, and those lacking access to healthcare, often experience greater challenges in managing their condition (Alupo et al., 2024).

These populations may face financial constraints that prevent them from accessing medications or healthcare services, resulting in worse symptoms and higher hospitalization rates. For example, individuals in remote areas may lack healthcare access, preventing timely treatment. Moreover, the inability to afford medications, such as inhalers or oxygen, or a lack of proper knowledge about COPD increases the likelihood of complications. Smoking cessation programs and regular healthcare visits can help alleviate these issues and reduce the risk of further complications (Wang et al., 2024). Nurses play a crucial role in educating patients and ensuring they receive adequate care for improved health outcomes.

Describing the Research Question

The need for smoking cessation in COPD patients is essential for slowing the disease’s progression and enhancing quality of life. However, many individuals encounter significant obstacles when trying to quit smoking. Developing a research question is vital for identifying the most effective methods to help these individuals overcome such challenges (Gosak et al., 2024). Using the PICO(T) framework, the research question is: In adult patients diagnosed with COPD (P), how does a structured smoking cessation program incorporating behavioral counseling and pharmacotherapy (I), compared to standard smoking cessation counseling (C), impact smoking cessation rates and pulmonary function (O) within six months (T)?

Breakdown of the PICO(T) Criteria

This research question aims to explore the effectiveness of structured smoking cessation programs in assisting COPD patients in quitting smoking and improving lung health. It will compare the effectiveness of these programs with standard counseling and provide insights into best practices for COPD management and patient outcomes.

Literature Search

A thorough literature search was conducted to identify relevant evidence on smoking cessation interventions for COPD patients. Academic databases such as PubMed, CINAHL, Cochrane Library, and Google Scholar were utilized to ensure a comprehensive range of high-quality sources. The search focused on keywords including “COPD,” “smoking cessation,” “nicotine replacement therapy,” “behavioral counseling,” “pharmacotherapy,” and “pulmonary rehabilitation.” Boolean operators (AND, OR) were applied to refine the search to studies specifically addressing smoking cessation in COPD patients, rather than general tobacco cessation. The CRAAP criteria (Currency, Relevance, Authority, Accuracy, and Purpose) were used to evaluate the credibility of the sources. Priority was given to peer-reviewed articles, systematic reviews, and meta-analyses from reputable organizations like the CDC and ALA. By using terms like “COPD patient adherence” and “effectiveness of structured cessation programs,” the search yielded studies directly addressing the research question. This systematic approach ensured the inclusion of reliable, applicable evidence for guiding evidence-based practice in COPD smoking cessation.

Relevant Articles

Three key studies provide strong evidence for the effectiveness of smoking cessation interventions in COPD patients. Wang et al. (2024) conducted a meta-analysis showing that individuals who quit smoking experienced significant improvements in lung function (FEV1% improved by 6.72), walking ability (6-MWT increased by 64.46), and oxygen levels (1.96 higher). Moreover, quitting smoking lowered the risk of mortality (RR = 0.75), emphasizing the importance of structured cessation programs. Han et al. (2023) evaluated the effectiveness of structured smoking cessation programs integrating behavioral counseling, pharmacotherapy, and pulmonary rehabilitation. Their randomized controlled trial (RCT) demonstrated that combining NRT with cognitive-behavioral interventions resulted in higher quit rates compared to standard counseling. Lastly, Fu et al. (2022) highlighted how evidence-based practice models, such as the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model, can support structured smoking cessation interventions. Their research showed that these programs improved pulmonary function and slowed COPD progression. Together, these studies provide compelling evidence supporting the use of structured smoking cessation programs for COPD patients.

Analyzing Evidence

The evidence overwhelmingly supports the use of structured smoking cessation programs that incorporate behavioral counseling and pharmacotherapy over standard smoking cessation counseling. Wang et al. (2024) found that smoking cessation led to significant improvements in lung function, walking ability, and oxygen levels. Additionally, smoking cessation reduced the risk of death, highlighting the essential role of structured interventions in managing COPD. Han et al. (2023) demonstrated that combining NRT and cognitive-behavioral interventions resulted in higher quit rates than standard counseling alone. Fu et al. (2022) emphasized the importance of integrating evidence-based practices in clinical settings to improve smoking cessation outcomes. The collective findings from these studies confirm that structured programs lead to higher cessation rates, improved pulmonary function, and better overall health outcomes, making them more effective than standard counseling in managing COPD.

Conclusion

Quitting smoking is critical for COPD patients as it helps slow disease progression and improves lung health. Structured smoking cessation programs that provide both support and pharmacotherapy are more effective than standard counseling. These programs contribute to better long-term health outcomes, such as improved lung function and reduced hospitalizations. Healthcare providers, including nurses, can use these programs to assist patients in quitting smoking, thereby improving their quality of life and reducing the burden of COPD.

References

Alupo, P., Baluku, J., Bongomin, F., Siddharthan, T., Katagira, W., Ddungu, A., Hurst, J. R., Boven, van, Worodria, W., & Kirenga, B. J. (2024). Overcoming challenges of managing chronic obstructive pulmonary disease in low- and middle-income countries. Expert Review of Respiratory Medicine. https://doi.org/10.1080/17476348.2024.2398639

American Lung Association (ALA). (2024). Learn about COPD | American Lung Association. Lung.org; American Lung Association. https://www.lung.org/lung-health-diseases/lung-disease-lookup/copd/learn-about-copd

Centers for Disease Control and Prevention (CDC). (2024, June 12). COPD. Chronic Disease Indicators. https://www.cdc.gov/cdi/indicator-definitions/chronic-obstructive-pulmonary-disease.html

Fu, Y., Chapman, E. J., Boland, A. C., & Bennett, M. I. (2022). Evidence-based management approaches for patients with severe chronic obstructive pulmonary disease (COPD): A practice review. Palliative Medicine, 36(5), 770–782. https://doi.org/10.1177/02692163221079697

NURS FPX 4025 Assessment 3

Gosak, L., Štiglic, G., Pruinelli, L., & Vrbnjak, D. (2024). PICOT questions and search strategies formulation: A novel approach using artificial intelligence automation. Journal of Nursing Scholarship. https://doi.org/10.1111/jnu.13036

Han, M. K., Fu, Y., Ji, Q., Duan, X., & Fang, X. (2023). The effectiveness of theory-based smoking cessation interventions in patients with chronic obstructive pulmonary disease: A meta-analysis. BMC Public Health, 23(1). https://doi.org/10.1186/s12889-023-16441-w

Hu, Y., Xie, J., Chang, X., Chen, J., Wang, W., Zhang, L., Zhong, R., Chen, O., Yu, X., & Zou, Y. (2021). Characteristics and predictors of abstinence among smokers of a smoking cessation clinic in Hunan China. Frontiers in Public Health, 9. https://doi.org/10.3389/fpubh.2021.615817

Wang, Z., Qiu, Y., Ji, X., & Dong, L. (2024). Effects of smoking cessation on individuals with COPD: A systematic review and meta-analysis. Frontiers in Public Health, 12. https://doi.org/10.3389/fpubh.2024.1433269