Care-paradigm shift promoting smoking cessation treatment among cancer center patients via a low-burden strategy, Electronic Health Record-Enabled Evidence-Based Smoking Cessation Treatment

Alex T. Ramsey, Ami Chiu, Timothy Baker, Nina Smock, Jingling Chen, Tina Lester, Douglas E. Jorenby, Graham A. Colditz, Laura J. Bierut, Li Shiun Chen

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

Tobacco smoking is an important risk factor for cancer incidence, an effect modifier for cancer treatment, and a negative prognostic factor for disease outcomes. Inadequate implementation of evidence-based smoking cessation treatment in cancer centers, a consequence of numerous patient-, provider-, and system-level barriers, contributes to tobacco-related morbidity and mortality. This study provides data for a paradigm shift from a frequently used specialist referral model to a point-of-care treatment model for tobacco use assessment and cessation treatment for outpatients at a large cancer center. The point-of-care model is enabled by a low-burden strategy, the Electronic Health Record-Enabled Evidence-Based Smoking Cessation Treatment program, which was implemented in the cancer center clinics on June 2, 2018. Five-month pre-and post-implementation data from the electronic health record (EHR) were analyzed. The percentage of cancer patients assessed for tobacco use significantly increased from 48% to 90% (z = 126.57, p <. 001), the percentage of smokers referred for cessation counseling increased from 0.72% to 1.91% (z = 3.81, p <. 001), and the percentage of smokers with cessation medication significantly increased from 3% to 17% (z = 17.20, p <. 001). EHR functionalities may significantly address barriers to point-of-care treatment delivery, improving its consistent implementation and thereby increasing access to and quality of smoking cessation care for cancer center patients.

Original languageEnglish
Pages (from-to)1504-1514
Number of pages11
JournalTranslational Behavioral Medicine
Volume10
Issue number6
DOIs
StatePublished - Dec 1 2020

Keywords

  • Cancer care facilities
  • Electronic health record
  • Point-of-care systems
  • Quality improvement
  • Referral and consultation
  • Smoking cessation

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