Provider feedback to improve 5A's tobacco cessation in primary care: A cluster randomized clinical trial

被引:95
作者
Bentz, Charles J.
Bayley, K. Bruce
Bonin, Kerry E.
Fleming, Lori
Hollis, Jack F.
Hunt, Jacquelyn S.
LeBlanc, Benjamin
McAfee, Tim
Payne, Nicola
Siemienczuk, Joseph
机构
[1] St Vincent Hosp & Med Ctr, Portland, OR 97225 USA
[2] Providence Hlth Syst, Portland, OR USA
[3] Free & Clear Inc, Seattle, WA USA
[4] Kaiser Permanente NW, Portland, OR USA
关键词
CONTINUING MEDICAL-EDUCATION; SMOKING-CESSATION; PREVENTIVE CARE; PHYSICIAN; GUIDELINES; INTERVENTIONS; METAANALYSIS; EXPERIENCE; PROGRAM;
D O I
10.1080/14622200701188828
中图分类号
R194 [卫生标准、卫生检查、医药管理];
学科分类号
摘要
The electronic health record ( EHR) may be an effective tool to help clinicians address tobacco use more consistently. To evaluate the impact of EHR-generated practice feedback on rates of referral to a state-level tobacco quitline, we conducted a cluster randomized clinical trial ( feedback versus no feedback) within 19 primary care clinics in Oregon. Intervention clinics received provider-specific monthly feedback reports generated from EHR data. The reports rated provider performance in asking, advising, assessing, and assisting with tobacco cessation compared with a clinic average and an achievable benchmark of care. During 12 months of follow-up, EHR-documented rates of advising, assessing, and assisting were significantly improved in the intervention clinics compared with the control clinics ( p<.001). A higher case-mix index and presence of a clinic champion were associated with higher rates of referral to a state-level quitline. EHR-generated provider feedback improved documentation of assistance with tobacco cessation. Connecting physician offices to a state-level quitline was feasible and well accepted.
引用
收藏
页码:341 / 349
页数:9
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