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A Computerized Aid to Support Smoking Cessation Treatment for Hospital Patients

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Abstract

Background

Hospital-based interventions promote smoking cessation after discharge. Strategies to deliver these interventions are needed, especially now that providing smoking cessation advice or treatment, or both, to inpatient smokers is a publicly reported quality-of-care measure for US hospitals.

Objective

To assess the effect of adding a tobacco order set to an existing computerized order-entry system used to admit Medicine patients to 1 hospital.

Design

Pre-post study.

Measurements and Main Results

Proportion of admitted patients who had smoking status identified, a smoking counselor consulted, or nicotine replacement therapy (NRT) ordered during 4 months before and after the change. In 4 months after implementation, the order set was used with 76% of Medicine admissions, and a known smoking status was recorded for 81% of these patients. The intervention increased the proportion of admitted patients who were referred for smoking counseling (0.8 to 2.1%) and had NRT ordered (1.6 to 2.5%) (p < .0001 for both). Concomitantly, the hospital’s performance on the smoking cessation quality measure improved.

Conclusions

Adding a brief tobacco order set to an existing computerized order-entry system increased a hospital’s provision of evidence-based tobacco treatment and helped to improve its performance on a publicly reported quality measure. It provides a model for US hospitals seeking to improve their quality of care for inpatients.

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Acknowledgment

There were no additional contributors to this manuscript. Sources of funding consist of the following: Brigham and Women’s Hospital, Department of Medicine, Medical Residency Office; NIH/NHLBI (Mid-Career Award in Patient-oriented Research to Dr. Rigotti - #K24 HL04440); and Partners HealthCare, Inc.

Conflict of Interest Statement

Kate Koplan, Susan Regan, and Louise Schneider have no conflicts of interest. Robert Goldszer has served as a consultant with Leader Health. Nancy Rigotti has served as a consultant with Pfizer and Sanofi-Aventis and has received grants from Pfizer, Sanofi-Aventis, and Nabi Biopharmaceuticals.

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Author notes

  1. Kate E. Koplan MD, MPH

    Present address: Harvard Vanguard Medical Associates, Boston, MA, USA

Authors and Affiliations

  1. Harvard Medical School, Boston, MA, USA

    Kate E. Koplan MD, MPH, Susan Regan PhD, Robert C. Goldszer MD, MBA, Louise I. Schneider MD & Nancy A. Rigotti MD

  2. Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, MA, USA

    Susan Regan PhD & Nancy A. Rigotti MD

  3. Tobacco Treatment Task Force, Partners HealthCare, Inc., Boston, MA, USA

    Kate E. Koplan MD, MPH, Louise I. Schneider MD & Nancy A. Rigotti MD

  4. Department of Internal Medicine, Brigham and Women’s Hospital, Boston, MA, USA

    Kate E. Koplan MD, MPH & Robert C. Goldszer MD, MBA

Authors
  1. Kate E. Koplan MD, MPH
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  2. Susan Regan PhD
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  3. Robert C. Goldszer MD, MBA
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  4. Louise I. Schneider MD
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  5. Nancy A. Rigotti MD
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Corresponding author

Correspondence to Kate E. Koplan MD, MPH.

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Koplan, K.E., Regan, S., Goldszer, R.C. et al. A Computerized Aid to Support Smoking Cessation Treatment for Hospital Patients. J GEN INTERN MED 23, 1214–1217 (2008). https://doi.org/10.1007/s11606-008-0610-4

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  • DOI: https://doi.org/10.1007/s11606-008-0610-4

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