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40
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Text
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URL Address
<a href="http://doi.org/10.18332/tpc/107116" target="_blank" rel="noreferrer noopener">http://doi.org/10.18332/tpc/107116</a>
Pages
4
Volume
5
ISSN
2459-3087
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Title
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An intervention based on the Electronic Medical Record to improve smoking cessation guidance in an urban tertiary care center emergency department
Publisher
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Tobacco Prevention & Cessation
Date
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2019
2019-05
Subject
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Emergency Medicine; smoking; Substance Abuse; united-states; guidance; smoking cessation; discharge; instructions
Creator
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Phelan M P; Nithianandam B; Eikoff N; Good D; Hustey F M; Meldon S
Description
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INTRODUCTION Smoking remains a major public health issue and a leading cause of death and disability in the United States. The objective of this study was to determine the effect of a simple intervention on smoking guidance, based on the electronic medical record (EMR), including providing discharge instructions and/or cessation counseling to emergency department (ED) patients who smoke. METHODS This was an interventional before-and-after study in an ED with 70000 visits per year. A pre-intervention and post-intervention chart review was performed on a random sample of ED visits occurring in 2014 and 2016, identifying smokers and the frequency with which smokers received discharge instructions and/or cessation counseling. In the fall of 2015, our EMR was programmed to deploy smoking cessation discharge instructions automatically. RESULTS In all, 28.7% (172/600; 95% CI: 25.2-32.4%) reported current smoking in the pre-intervention ED population and 27.6% (166/600; 95% CI: 24.2-31.4%) reported smoking in the post-intervention population. Smoking cessation guidance was provided to a total of 3.5% of self-reported smokers in the pre-intervention group (6/172; 95% CI: 1.4-7.6%); 1.2% (2/172; 95% CI: 0.3-4.1%) were informed of smoking cessation resources as part of their printed ED discharge instructions and 2.3% (4/172; 95% CI: 0.9-5.8%) received smoking cessation counseling by the ED provider. There was a statistically significant increase in the proportion of patients receiving any smoking cessation guidance after the intervention. All patients (166/166; 95% CI: 97-100% in this period received ED discharge instructions and a list of smoking cessation resources and 3.6% of smokers (6/166; 95% CI: 1.7-7.7%) received smoking cessation counseling by the ED provider. CONCLUSIONS Automated deployment of smoking cessation discharge instructions in the EMR improves smoking cessation discharge instructions, and also has a positive impact on improving rates of in-person counseling by ED providers.
Identifier
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<a href="http://doi.org/10.18332/tpc/107116" target="_blank" rel="noreferrer noopener">10.18332/tpc/107116</a>
Rights
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Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
2019
discharge
Eikoff N
Emergency Medicine
Good D
guidance
Hustey F M
instructions
June 2019 Update
Meldon S
NEOMED College of Medicine
NEOMED College of Medicine Student
NEOMED Student Publications
Nithianandam B
Phelan M P
Smoking
Smoking Cessation
Substance Abuse
Tobacco Prevention & Cessation
united-states