Clinical Testing of a Decision Support System for Tobacco Use Treatment
- Test the hypothesis that the clinical decision support system will improve the rate at
which physicians assist their patients with smoking cessation by providing information
and recommendations on smoking cessation resources.
- Assess whether exposure to information and recommendations facilitated by the smoking
cessation-personal digital assistant (SC-PDA) will increase the rate at which patients
make at least 1 attempt to quit smoking in the month following the physician visit.
- Assess whether exposure to information and recommendations facilitated by the SC-PDA
will increase the reported use of counseling and pharmacotherapy during those attempts
over that observed with a smoking status identification system alone.
- Evaluate the acceptance of the SC-PDA into the workflow of ambulatory care clinics.
OUTLINE: In weeks 1-12, physicians have access to a smoking status identification system
(SSID) that reminds the physician the smoking status of the patient they are evaluating. In
weeks 6-12, physicians have access to a computerized smoking cessation clinical decision
support system using a hand-held personal digital assistant (SC-PDA) that they can use in
the exam room with their patients who smoke. The SC-PDA system assists physicians in
recommending and prescribing approved pharmacotherapy; facilitates referral of patients to
local counseling resources; prints a tailored handout for a patient listing specific
recommendations, instructions, and cessation resources; and generates the necessary
documentation to support billing for this intervention.
Patients who visit their physician in weeks 2-6 or weeks 8-12 complete a survey after their
clinic visit and undergo a telephone interview 1 month later. Physicians undergo interviews
and focus groups are conducted with clinic staff in weeks 12-16.
Primary Purpose: Health Services Research
Physician adherence to the United States Public Health Service's Tobacco Use and Dependence Treatment guideline (USPHS Guideline) as measured by the patient exit survey
Theodore W. Marcy, MD, MPH
University of Vermont
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