Personalizing tobacco cessation utilizing clinic decision support [presentation] Presentation uri icon

abstract

  • Objective: Tobacco use impacts oral health. Current evidence suggests dental providers ask about tobacco use but don't assist the patient in tobacco cessation. Approaches that provide patient-specific recommendations may be a more effective strategy to improve tobacco cessation. In this study, we examined the impact of a tobacco cessation tool integrated with electronic health records (EHR) on providing individualized tobacco cessation interventions. Method: This study was a blocked, group-randomized trial within the HealthPartners Dental Group (HPDG) clinics where the unit of randomization and patients nested within each randomized clinic represent the lowest level unit of observation. All providers assessed tobacco use including type, amount, dependency questions and interest in quitting. The intervention clinics were provided suggested personalized scripts for the provider to deliver. The script combinations considered dependency, prior attempts and interest in quitting. Sixteen different script combinations were developed. Primary outcomes were patient reports of the provider assessing interest in quitting, delivering a brief intervention and referring to a quitline. The outcome measure came from a random sample of smokers surveyed by phone 1-3 days after the dental appointment. Data recorded by providers in the electronic dental record was also examined. Result: Dental providers assessed interest in quitting (control 71% vs. intervention 89%; p=.0001), discussed specific strategies for quitting (control 25% vs. intervention 48%; p=.003) and referred the patient to a tobacco quitline (control 17% vs. intervention 39%; p=.007). Conclusion: Tobacco cessation tools integrated with EHRs and tailored to the individual smoker’s level of tobacco use, dependency, prior quit attempts and interest in quitting is an effective approach to improve the delivery of tobacco interventions in dental offices. This tool, developed with user-centered design principles, increased the likelihood of adoption by providers. This approach holds promise as an example of a tool to personalize the delivery of evidence into daily clinical practice.