Primary Care Physicians' Use of Stop-Smoking Plans to Help Patients Who Are Smokers
|ClinicalTrials.gov Identifier: NCT00227786|
Recruitment Status : Completed
First Posted : September 28, 2005
Last Update Posted : August 16, 2013
RATIONALE: Stop-smoking plans suggested by physicians may help patients quit smoking. Studying how physicians give stop-smoking treatment as family doctors may increase the chance of smokers receiving such treatment.
PURPOSE: This randomized clinical trial is studying physicians' practice patterns to see if regular feedback to the physician increases the chance of adult smokers receiving stop-smoking treatment.
|Condition or disease||Intervention/treatment||Phase|
|Tobacco Use Disorder Unspecified Adult Solid Tumor, Protocol Specific||Behavioral: smoking cessation intervention Other: counseling intervention||Not Applicable|
- Develop an automated coding system using existing electronic medical records (EMRs) to assess adherence to national tobacco-cessation treatment guidelines by individual physicians in the primary care setting at 4 health maintenance organizations.
- Compare the validity of the automated coding system with that of coding performed by medical record abstractors.
- Determine the effect of performance feedback on tobacco treatment practice patterns over 2 years among primary care physicians.
- Provide recommendations for recording tobacco-cessation treatment services in EMR systems and evaluating adherence to treatment guidelines.
- Produce a set of computer programs that can be easily adopted in diverse health care settings for assessing adherence to the national tobacco-cessation treatment guidelines using data from EMRs.
OUTLINE: This is a randomized, controlled, multicenter study. Physicians from each participating center are sorted into pairs according to their rate of providing advice to quit smoking to identified adult smokers and the number of identified adult smokers seen in the 3-month baseline observation period. Each physician in the pair is then randomized to 1 of 2 arms.
- Arm I (automated coding system feedback): Physicians receive reports from an automated coding system regarding their performance in administering tobacco-cessation services in each of the five A's (Ask, Advise, Assess, Assist, and Arrange) to identified smokers in comparison with their past performance and in comparison with their anonymous colleagues once every 3 months. One year after randomization, these physicians are further randomized, using the same paired-group approach, to either continue receiving automated coding system feedback for 1 additional year OR to stop receiving feedback.
Physicians receive a survey at the end of 2-year period regarding the usefulness of each aspect of the feedback reports and the feedback program in general.
- Arm II (control): Physicians do not receive any information regarding their performance in administering tobacco-cessation services in each of the five A's to identified smokers.
A questionnaire about tobacco-cessation services in primary care is sent to patients of all physicians within two weeks of each patient's primary care visit and then at the end of the first year of providing feedback to physicians to compare patient report of tobacco-cessation services with what is documented in the electronic medical record for that primary care visit.
PROJECTED ACCRUAL: At least 40 primary care physicians per participating center and 1,000 patients (250 per participating center) will be accrued for this study.
|Study Type :||Interventional (Clinical Trial)|
|Actual Enrollment :||344 participants|
|Intervention Model:||Single Group Assignment|
|Official Title:||Using Electronic Medical Records to Measure and Improve Adherence to Tobacco Treatment Guidelines in Primary Care|
|Study Start Date :||January 2003|
|Actual Primary Completion Date :||May 2006|
|Actual Study Completion Date :||May 2006|
- Change in tobacco cessation care delivery of the 5 A's (Ask, Advise, Assess, Assist, and Arrange) and in the percentage of smokers receiving assistance as measured by MediClass classification at 18 months
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00227786
|United States, Colorado|
|Kaiser Permanente - Aurora|
|Aurora, Colorado, United States, 80014|
|United States, Hawaii|
|Kaiser Permanente Center for Health Research - Hawaii|
|Honolulu, Hawaii, United States, 96817|
|United States, Massachusetts|
|Massachusetts General Hospital Cancer Center|
|Boston, Massachusetts, United States, 02114|
|Harvard Pilgrim Health Care|
|Boston, Massachusetts, United States, 02215|
|United States, Oregon|
|Kaiser Permanente Center for Health Research|
|Portland, Oregon, United States, 97227|
|Study Chair:||Victor J. Stevens, PhD||Kaiser Permanente|