An intervention based on the Electronic Medical Record to improve smoking cessation guidance in an urban tertiary care center emergency department

Title

An intervention based on the Electronic Medical Record to improve smoking cessation guidance in an urban tertiary care center emergency department

Creator

Phelan M P; Nithianandam B; Eikoff N; Good D; Hustey F M; Meldon S

Publisher

Tobacco Prevention & Cessation

Date

2019
2019-05

Description

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.

Subject

Emergency Medicine; smoking; Substance Abuse; united-states; guidance; smoking cessation; discharge; instructions

Identifier

Rights

Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).

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Pages

4

Volume

5

ISSN

2459-3087

Citation

Phelan M P; Nithianandam B; Eikoff N; Good D; Hustey F M; Meldon S, “An intervention based on the Electronic Medical Record to improve smoking cessation guidance in an urban tertiary care center emergency department,” NEOMED Bibliography Database, accessed July 23, 2021, https://neomed.omeka.net/items/show/6452.

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