SRF048: Patient-Centered Tobacco Cessation Workflow for Healthcare clinics

Priscila Ibarra Becerra, MD; Christine Camacho, MD; Sireesha Teegala, MD; Melanie Perez Dones, MD; Alexis Ramos, MD; Jasmine Rodriguez, MPH; Etny Candelario; Carlos Jaen, MD, PhD; Arlene Reyes, MD; Fehima Dawy; Carolina Gutierrez Garcia


Objective: Increase tobacco cessation encounters in the Family Health Center by developing a protocol that will encourage a culture in which both providers and patients are empowered to discuss and actively engage in tobacco cessation.
Study Design: Quality improvement study. A protocol was designed to help providers initiate discussion regarding tobacco cessation during a provider visit. The encounter was documented within the electronic medical record and Quitxt enrollment (a free tobacco cessation coaching program).
Setting:Family Health Center, a primary care clinic within the UT Health system in San Antonio, Texas.
Population Studied: Adults 18 & above who presented for routine care.
Intervention: Patients who screened positive for smoking were assessed for readiness to quit. If interested in quitting they were then introduced to the Quitxt program. Either they declined enrollment, elected to think about enrolling at a future date, enrolled in the program during the visit or enrolled at some point after the visit.
Outcome measures: Percentage of tobacco cessation encounters resulting in enrollment in Quitxt program.
Results: Data from our EMR showed enrollment of 24 patients. Data from Quitxt showed enrollment of 20 patients between 09/12/2019 - 06/08/2020. This discrepancy between EMR and direct Qtxt data could be due to lack of differentiating within the EMR whether the encounter was simply an introduction to Quitxt vs. if the patient was actually enrolled in the Qtxt program. Overall, 67 patients were screened. Median number of encounters were 2 per patient, with a total of 148 encounters. 35% enrolled and 37.3% were considering it and only 26.9% declined. Interestingly, we also found that ⅔ of the patients were identified as interested in quitting after the provider initiated discussion regarding tobacco cessation. While these outcomes were not statistically significant, we found that there is benefit to designing a protocol that empowers providers to initiate tobacco cessation discussion with their patients, given patients who identified as interested in quitting would not have otherwise volunteered that information to the provider.
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Jack 11/21/2020

great job. thanks

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