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  • Title: Smoking cessation in primary care: a clinical effectiveness trial of two simple interventions.
    Author: Milch CE, Edmunson JM, Beshansky JR, Griffith JL, Selker HP.
    Journal: Prev Med; 2004 Mar; 38(3):284-94. PubMed ID: 14766110.
    Abstract:
    BACKGROUND: Many primary care practices do not have systematic protocols to identify patients who smoke or to encourage clinicians to provide smoking cessation advice. We designed a study to assess the relative effectiveness of two brief interventions on screening for smoking, physician cessation advice and patient smoking cessation rates. METHODS: We performed a nonrandomized comparison of alternative strategies for smoking cessation at a hospital-based adult primary care practice. Each intervention was implemented on a separate practice team. The "minimal" intervention consisted of a smoking status "vital sign" stamp which documented patient smoking status. The "enhanced" intervention consisted of a five-question form that assessed patient level of cessation readiness and provided cessation-counseling prompts for clinicians. Medical record documentation of screening for smoking and cessation advice and self-reported patient smoking cessation rates were collected 8-10 months after implementation. RESULTS: Smoking status was documented at 86%, 91%, and 49%, and cessation advice at 38%, 47%, and 30% of visits on the minimal, enhanced, and control teams, respectively (P < 0.001 for smoking status and P = 0.014 for advice). Self-reported patient smoking cessation was higher on the enhanced team (12%) compared with the minimal (2%) and control (4%) teams (P < 0.001). CONCLUSIONS: A short questionnaire that assesses readiness-to-quit and provides documentation of cessation advice improves rates of clinician cessation advice and patient smoking cessation compared with no intervention.
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