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Recruiting and engaging smokers in treatment in a primary care setting: developing a chronic care model implemented through a modified electronic health record

  • Original Research
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Translational Behavioral Medicine

ABSTRACT

Almost 35 million U.S. smokers visit primary care clinics annually, creating a need and opportunity to identify such smokers and engage them in evidence-based smoking treatment. The purpose of this study is to examine the feasibility and effectiveness of a chronic care model of treating tobacco dependence when it is integrated into primary care systems using electronic health records (EHRs). The EHR prompted primary care clinic staff to invite patients who smoked to participate in a tobacco treatment program. Patients who accepted and were eligible were offered smoking reduction or cessation treatment. More than 65 % of smokers were invited to participate, and 12.4 % of all smokers enrolled in treatment—30 % in smoking reduction and 70 % in cessation treatment. The chronic care model developed for treating tobacco dependence, integrated into the primary care system through the EHR, has the potential to engage up to 4.3 million smokers in treatment a year.

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Acknowledgements and funding

We would like to acknowledge the staff at Aurora Health Care and Dean Health System for their collaboration in this research. This research was supported by grant 9P50CA143188-12 from the National Cancer Institute and by the Wisconsin Partnership Program. Dr. Baker was supported via NCI 1K05CA139871. Dr. Cook was supported by K08DA021311.

Author information

Authors and Affiliations

  1. Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, 1930 Monroe St., Suite 200, Madison, WI, 53711, USA

    Megan E Piper PhD, Timothy B Baker PhD, David L Fraser PhD, Douglas E Jorenby PhD, Stevens S Smith PhD, Bruce A Christiansen PhD, Tanya R Schlam PhD, Jessica W Cook PhD, Madeline Oguss BA & Michael C Fiore MD, MPH, MBA

  2. Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA

    Robin Mermelstein PhD

  3. The Methodology Center, Pennsylvania State University, State College, PA, USA

    Linda M Collins PhD

Authors
  1. Megan E Piper PhD
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  2. Timothy B Baker PhD
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  3. Robin Mermelstein PhD
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  4. Linda M Collins PhD
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  5. David L Fraser PhD
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  6. Douglas E Jorenby PhD
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  7. Stevens S Smith PhD
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  8. Bruce A Christiansen PhD
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  9. Tanya R Schlam PhD
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  10. Jessica W Cook PhD
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  11. Madeline Oguss BA
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  12. Michael C Fiore MD, MPH, MBA
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Corresponding author

Correspondence to Megan E Piper PhD.

Additional information

Implications

Practice: Electronic health records (EHRs) should be used to prompt primary care clinic staff to offer all smokers evidence-based smoking interventions, with treatment provided by non-physician clinical staff.

Policy: Healthcare systems should implement a chronic care approach to treating smokers that uses the EHR to identify and offer treatment to all tobacco users at every visit and then provide care via trained chronic care case managers.

Research: Research needs to determine optimal ways of using the EHR to organize tobacco interventions and the effectiveness of incorporating chronic care approaches (including smoking reduction interventions) into healthcare delivery.

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Piper, M.E., Baker, T.B., Mermelstein, R. et al. Recruiting and engaging smokers in treatment in a primary care setting: developing a chronic care model implemented through a modified electronic health record. Behav. Med. Pract. Policy Res. 3, 253–263 (2013). https://doi.org/10.1007/s13142-012-0178-8

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  • DOI: https://doi.org/10.1007/s13142-012-0178-8

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