1. amount of tobacco users in each group
Start Talkin’
Stimulating Tobacco Cessation Counseling at Point of Care
Amanda W. Cardella DO, Alison Mancuso DO, Thomas Dinzeo PhD, Katharine Garnier MD Rowan University School of Osteopathic Medicine – Department of Family Medicine – Stratford, NJ
STUDY GROUP
CONTROL GROUP
BACKGROUND
Physician advice has a substantial effect on the success of tobacco cessation. However, a minimal number of patients report discussing this topic.
At baseline, similar
amount of tobacco users in each group
HYPOTHESIS
The authors hypothesize a visual in the exam room stimulates discussion during an office visit.
RESULTS
At baseline, data was obtained from 12,675 patient visits. In the control group, the rate of tobacco users was 14.97%. Discussions were documented at 70.66% of visits, which increased by 3.16% to 73.83%. In the study group, the rate of use was 12.41%. Discussions were documented at 52.93% of visits. After poster placement at the study sites, there was an 8.59% (p=0.0147) increase in the number of discussions to 61.52%. Thirteen physician survey responses (out of twenty requested) were received. Forty-six percent responded the poster had an effect on patient-initiated discussions. Fifty-three percent did not think the poster had an impact on physician-initiated discussions.
METHODS
A baseline three-month retrospective chart review in an academic practice was conducted to determine whether tobacco use was discussed. The author placed a poster depicting complications within exam rooms in two out of four locations. After three months the chart review was repeated comparing the two offices with posters (study group) to the two without (control group). A brief online survey was sent to the study group’s physicians regarding whether posters increased discussions.
CONCLUSION
This study demonstrates posters minimally increase discussions. The control group had more discussions documented. This could be due to a number of factors including attending physicians at that site having a greater focus on tobacco cessation when precepting resident physicians. Analysis of the survey results is limited due to poor response numbers. The majority of physician respondents did not feel posters increased discussions. This is likely due to the fact that discussions were increased minimally. We estimate that over 6,000 patients viewed the posters. This inexpensive reminder may be helpful to stimulate dialog regarding tobacco cessation in physician offices for some patients. Further studies could show this impact on a greater scale.
GENDER
RACE
No gender, race, or age differences in study comparisons before or after intervention
ACKNOWLEDGEMENT
The authors thank Rowan Family Medicine for support with this project. The study was approved by Rowan University’s Institutional Review Board.