In a significant development regarding smoking cessation efforts, prescriber incentives have led to a notable increase in the use of nicotine replacement therapy (NRT) at discharge. Taylor Fewox, PharmD, a PGY-2 psychiatry pharmacy resident at the Medical University of South Carolina, discussed these findings during the 2025 American Society of Health-System Pharmacists (ASHP) Midyear Clinical Meeting & Exhibition. The introduction of these incentives resulted in more prescriptions for NRT, although some did not align with the therapies patients received while hospitalized.
The evaluation originated from a previous report identifying inadequate NRT prescribing within the psychiatry department of the healthcare system. Fewox explained, “We wanted to see what we were doing on our end to make sure that we were doing our part in prescribing the most accurate for our patients.” This initiative aimed to enhance patient care by ensuring proper access to smoking cessation resources.
Impact of Incentives on NRT Prescribing Patterns
Following the implementation of prescriber incentives, the team observed a marked increase in NRT prescriptions, particularly nicotine patches. “We saw an increase in the number of NRT that were prescribed upon discharge,” Fewox noted. Despite this uptick, there was a concern regarding the appropriateness of some prescriptions, as they did not always reflect patients’ actual usage during their inpatient stay.
The enhanced access to NRT was further supported by the utilization of the indigent fund, which allowed more patients to receive the necessary therapies. Fewox emphasized that this funding played a crucial role in facilitating patient access to smoking cessation support. “If they did want to quit smoking or work on that journey for themselves, we had that avenue for them to go,” he added.
Lessons for Health Systems and Future Directions
Fewox highlighted the importance of interdisciplinary collaboration among pharmacists, psychiatrists, nurses, and tobacco cessation specialists. “It’s more interdisciplinary, so looking at not only us as the pharmacists but also our psychiatrists as well as our nurses and our tobacco cessation group,” he explained. This teamwork is essential to ensure that patients receive comprehensive support throughout their cessation journey.
Looking ahead, Fewox and his team plan to refine their approach to NRT prescribing. They aim to incorporate motivational interviewing techniques to better understand patients’ needs and preferences. This initiative seeks to provide not only NRT at discharge but also additional resources tailored to individual patient circumstances.
In summary, the evaluation of prescriber incentives has yielded positive outcomes in NRT utilization, underscoring the potential benefits of such initiatives in improving smoking cessation efforts. As health systems continue to explore effective strategies, the experiences shared by Fewox and his team may serve as a valuable guide for enhancing patient support in tobacco cessation.
