Article

A computerized aid to support smoking cessation treatment for hospital patients

Harvard Medical School, Boston, MA, USA.
Journal of General Internal Medicine (Impact Factor: 3.42). 05/2008; 23(8):1214-7. DOI: 10.1007/s11606-008-0610-4
Source: PubMed

ABSTRACT Hospital-based interventions promote smoking cessation after discharge. Strategies to deliver these interventions are needed, especially now that providing smoking cessation advice or treatment, or both, to inpatient smokers is a publicly reported quality-of-care measure for US hospitals.
To assess the effect of adding a tobacco order set to an existing computerized order-entry system used to admit Medicine patients to 1 hospital.
Pre-post study.
Proportion of admitted patients who had smoking status identified, a smoking counselor consulted, or nicotine replacement therapy (NRT) ordered during 4 months before and after the change. In 4 months after implementation, the order set was used with 76% of Medicine admissions, and a known smoking status was recorded for 81% of these patients. The intervention increased the proportion of admitted patients who were referred for smoking counseling (0.8 to 2.1%) and had NRT ordered (1.6 to 2.5%) (p < .0001 for both). Concomitantly, the hospital's performance on the smoking cessation quality measure improved.
Adding a brief tobacco order set to an existing computerized order-entry system increased a hospital's provision of evidence-based tobacco treatment and helped to improve its performance on a publicly reported quality measure. It provides a model for US hospitals seeking to improve their quality of care for inpatients.

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    • "Identifying smoking status and recording increases the rate of clinical intervention, which has been shown to increase cessation attempts (Raw et al., 1998; Fiore et al., 2008). Automatic electronic medical records and decision-support systems could therefore, as facilitators of systematic interventions, improve hospital-based cessation support (Williams et al., 2005; Koplan et al., 2007). Implementing a tobacco measure in the national hospital quality-of-care standards, as is already the case in the United States, is also a crucial tool (Fiore et al., 2012). "
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