1. Development and Effectiveness of a Multi-layered
Tobacco Cessation Program for Cancer Patients
Vance Rabius, PhD, Jason D. Robinson, PhD, Janice A. Blalock PhD, Maher Karam-Hage, MD, Paul M. Cinciripini, PhD
Department of Behavioral Science, The University of Texas MD Anderson Cancer Center , Houston, TX
Patients Served – September 1, 2012 to August 31, 2013
Disclosures
The authors are supported in part by the NCI P30 CA16672 Cancer Center Support Grant to MD Anderson. The Tobacco Treatment Program is supported by State of Texas Tobacco Settlement Funds. Paul M. Cinciripini is a site principal investigator and Maher Karam-Hage is a co-investigator on a clinical trial sponsored by Pfizer. They have also received grants and nonfinancial support from Pfizer, including medication for an NIH-funded trial.
Introduction
Since 2006 the Tobacco Treatment Program (TTP) has provided smoking cessation treatment to patients and employees at MD Anderson Cancer Center (MDACC). The TTP provides a program of behavioral counseling and pharmacotherapy for smoking cessation, in combination with psychotherapy and/or psychiatric treatment for conditions directly affecting a cessation attempt. In this study we report the impact of enhancing provider-driven referrals with automatic electronic referrals (AERs) based on self-reported tobacco use in a patient’s electronic health record (EHR) and on the expansion of our service offerings to reach all patients who smoke.
Referral Processing – Service Offerings
Service
Number
Percent
EMS1 – Educational Intervention and Follow-up
1072
21%
EMS2 – Motivational Intervention and Follow-up
3184
62%
PO – Phone Counseling and Follow-up Support 86 2%
TTP1 – Counseling and Pharmacotherapy
760
15%
Total
5102
100%
Abstinence Rates and Response Rates at 3 Months
Results
From September 1, 2012 to August 31, 2013, the TTP received 5102 eligible, unique patient referrals
Service
N Quit / N
% Quit
Response Rate
EMS1
93/1072 9%
16%
EMS2
227/3184 7%
17% PO
15/86
50%
TTP1
257/760
34%
73%
Average Number of Referrals per Day by Week
April 30, 2012 through August 31, 2013
Conclusions
A multi-layered service offering has extended TTP’s reach. Higher abstinence rates were associated with counseling services (in-person and phone) and the highest rate was associated with counseling plus pharmacotherapy.
TTP Enhancement Timeline
Feb 2012 – Staff begin Motivational Interviewing training
Jul – AER from EHR implemented
Sep 2012 – Patient Education/Motivational services implemented
May 2013 – Phone option offered
Contact information
Vance Rabius, PhD
University of Texas MD Anderson Cancer Center
Department of Behavioral Science-Unit 1330
PO Box
Houston Texas,
(V) (fax)