Smoking screening and management in primary care practices
P. E. McBride, M. B. Plane, G. Underbakke, R. L. Brown and L. I. Solberg
Department of Family Medicine, University of Wisconsin Medical School, Madison, USA.
OBJECTIVES: To describe the screening and management of patients who smoke
by primary care physicians and to review practice factors associated with
smoking services. DESIGN AND METHODS: A descriptive study based on
physician and patient questionnaires and medical record retrospective
reviews. SETTING AND SUBJECTS: Forty-five nonacademic primary care
practices, including 160 physicians (whose subspecialty is family practice,
internal medicine, or general practice) in 4 Midwest states and 4879 adult
patients who completed questionnaires and consented for medical record
review. MAIN OUTCOME MEASURES: The a priori hypothesis was that screening
by physicians would detect most persons who smoke, but that the lack of
systematic methods to screen, intervene, or follow-up would limit the
provision of smoking cessation services. RESULTS: Eighty-one percent of all
patients and 93% of patients who smoked in the past 2 years reported being
asked if they smoked. Patients who smoked reported being told to quit
(78%), discussing a quit data (60%), receiving a nicotine prescription
(20%) or referral (25%) at higher rates than prior reports. Patients with
coronary heart disease (CHD) or CHD risk factors, who smoked more, visited
the physician more, or who wanted help were more likely to receive smoking
cessation services. Few practices had developed systems to routinely
provide services, and a lack of systems was associated with fewer
interventions. CONCLUSIONS: Physician screening and management of their
practice patients is higher than reported in population surveys. Most
patients who smoke report that they were asked whether they smoke, but
smoking status is not routinely documented or updated. Significant
variability is noted between physicians in smoking-related screening and
interventions, and proved methods to improve services are infrequently
used.
Smoking Status as a Clinical Indicator for Alcohol Misuse in US Adults
McKee et al.
Arch Intern Med 2007;167:716-721.
ABSTRACT
| FULL TEXT
Design and testing of an interactive smoking cessation intervention for inner-city women
McDaniel et al.
Health Educ Res 2005;20:379-384.
ABSTRACT
| FULL TEXT
Effectiveness of Implementing the Agency for Healthcare Research and Quality Smoking Cessation Clinical Practice Guideline: A Randomized, Controlled Trial
Katz et al.
JNCI J Natl Cancer Inst 2004;96:594-603.
ABSTRACT
| FULL TEXT
Incentivising, facilitating, and implementing an office tobacco cessation system
Solberg
Tobacco Control 2000;9:i37-41.
FULL TEXT
Tools to Improve Documentation of Smoking Status: Continuous Quality Improvement and Electronic Medical Records
Spencer et al.
Arch Fam Med 1999;8:18-22.
ABSTRACT
| FULL TEXT
Primary Care Practice Adherence to National Cholesterol Education Program Guidelines for Patients With Coronary Heart Disease
McBride et al.
Arch Intern Med 1998;158:1238-1244.
ABSTRACT
| FULL TEXT
National Patterns in the Treatment of Smokers by Physicians
Thorndike et al.
JAMA 1998;279:604-608.
ABSTRACT
| FULL TEXT
