THU0735-HPR How rheumatology specialist nurse detects smoking habit in rheumatoid chronic inflammatory disease pacients
Authors: M. Serra Miralles, F. Abella, N. Montalà, M. Mateu, A. Palau, M. Conde, L. Roselló
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Inflammation plays a significant role in the development of atherosclerosis and cardiovascular disease (CVD). Patients with chronic inflammatory disease (CID) have an increased risk of CVD. Smoking is one of the main risk factors for CVD and a predictor of poor response to treatment and poor prognosis. <h3>Objectives</h3> We aimed to describe the role on a rheumatology specialist nurse in the detection of smoking habit and dependence to nicotine in CID patients before the start of an interventionism plan to avoid it in CID patients. <h3>Methods</h3> All CID patients attended in a nurse rheumatologist unit, during one month, were asked for smoking habit. We determined the characteristics, onset of smoking and number of cigarettes per day. The Fagerström test was used to establish the nicotine dependence (ND) (score &gt;5) and the Richmond test for predicting abstention following intervention to stop smoking (score &gt;5). Exhaled CO level Coximetry was also recorded. We planned an interventionism consenting in health advice provided by a nurse and the derivation to a smoke unit. <h3>Results</h3> 22 patients were identified. 12 (50.0%) were female and mean age was 46.0 (SD 10.5). 14 (63.6%) suffered Rheumatoid Arthritis, 6 (27.3%) Ankylosing Spondylitis and 2 (9.1%) Psoriatic Arthritis. 5 (22.7%) subjects were under biological treatment. Mean number of cigarettes smoked per day and smoking years were 16.0 (SD 8.9) cigarettes and 27.2 (SD 11.7) years respectively. Up to 5 out of 22 (22.7%) subjects had high ND. Patients with ND had higher exhaled CO levels than non ND subjects (24.6 [SD 6.0] vs. 17.9 [SD 12.2] p-value 0.160). We observed no differences in age, sex, rheumatoid diagnosis, years smoking or cigarettes per day between both groups. Active treatment with biological drugs was significantly associated with ND (60.0 vs. 14.3%, p-value 0.046). One out of five patients with ND had good abstention prediction according to Richmond test <h3>Conclusions</h3> Nearly one out of five smoking CID subjects had severe ND. Treatment with biological drugs was related to ND. Interestingly, most of the ND subjects had good prediction for smoking cessation. Therefore, the development of a nurse program to detect smoking and our interventionism plan to avoid smoking habit are of enormous interest. <h3>References</h3> [1] Oliver S, Leary A. The value of the nurse specialists' role: Pandora initial findings. Musculoskeletal Care2010;8:175–7. [2] Soderlin MK, Petersson IF, Geborek P. The effect of smoking on response and drug survival in rheumatoid arthritis patients treated with their first anti-TNF drug. Scand J Rheumatol2012;41:1–9. [3] Chang K, Yang SM, Kim SH, Han KH, Park SJ, Shin JI. Smoking and rheumatoid arthritis. Int J Mol Sci2014;15:22279–95. [4] Roelsgaard IK, Thomsen T, Ostergaard M, et al. The effect of an intensive smoking cessation intervention on disease activity in patients with rheumatoid arthritis: study protocol for a randomised controlled trial. Trials2017;18:570. <h3>Disclosure of Interest</h3> None declared