scholarly journals An Interdisciplinary Response to a Tobacco Cessation Case Vignette

2016 ◽  
Vol 12 (3) ◽  
pp. 153-164
Author(s):  
Chad D. Morris ◽  
Donna L. Richardson ◽  
Jill M. Loewen ◽  
Laura C. Vanheest ◽  
Angela Brumley-Shelton ◽  
...  
Keyword(s):  
Tobacco Use ◽  
Tobacco Cessation ◽  
Interdisciplinary Approach ◽  
Chronic Illnesses ◽  
Mental Illnesses ◽  
Case Vignette ◽  
Care Needs ◽  
Healthcare Settings ◽  
Tobacco Treatment ◽  
Complex Care Needs

Introduction:Tobacco use is a chronic, relapsing condition. While there are proven cessation medications and counselling treatments, uptake of available aids is poor and smokers often do not have access to evidence-based services.Aims:The Association for the Treatment of Tobacco Use and Dependence (ATTUD) is an organisation of tobacco treatment specialists (TTSs) representing a wide array of disciplines and healthcare settings. This case vignette was intended to provide a clinical example of an interdisciplinary approach to tobacco use treatment.Methods:ATTUD Interdisciplinary Committee members representing tobacco-cessation experts from five professions were asked to respond to the same composite case vignette detailing key areas of clinical consideration and treatment.Results/Findings:While there were common treatment themes across professions, each provider also offered a unique treatment perspective addressing different facets of the patient's complex care needs, including attention to other chronic illnesses, mental illnesses, and preventive services. Expert responses highlighted that different treatment approaches across a continuum of healthcare settings are complementary.Conclusions:Responses to this vignette support the need to address tobacco use from an interdisciplinary approach. Existing chronic care and patient-centred models should be utilised to ensure that tobacco users receive a sufficient range of cessation services.

scholarly journals Potential Social, Environmental, and Regulatory Threats to Electronic Health Record Strategies for Improving Tobacco Treatment in Healthcare

2013 ◽  
Vol 8 (2) ◽  
pp. 106-114
Author(s):  
Frank T. Leone ◽  
Sarah Evers-Casey ◽  
Michael J. Halenar ◽  
Keiren O'Connell ◽  
Keyword(s):  
Tobacco Use ◽  
Treatment Guidelines ◽  
Topic Area ◽  
Healthcare Settings ◽  
Tobacco Treatment ◽  
Potential Impact ◽  
Electronic Health ◽  
Social Environmental ◽  
The Impact ◽  
Optimal Implementation

Introduction– The potential impact of electronic health records (EHR) in driving tobacco treatment behaviours within healthcare settings has been established. However, little is known about the administrative variables that may undermine effectiveness in real world settings.Aims– Assist healthcare planners interested in implementing tobacco-EHR systems by identifying an EHR framework that is consistent with published treatment guidelines, and the important organisational variables that can undermine the effectiveness of tobacco-EHR.Methods– This paper considers the established literature on EHR implementation and physician behaviour change, and integrates this understanding with the observations of an expert workgroup tasked with facilitating tobacco-EHR implementation in Southeastern Pennsylvania.Results/ Findings– System change in this topic area will continue to be problematic unless attention is paid to several important lessons regarding: 1) the evolving healthcare regulatory environment, 2) the integration of tobacco use treatment into primary care, and 3) the existing social and organisational barriers to uptake of evidence-based recommendations.Conclusion– Healthcare organisations seeking to reduce the impact of tobacco use on their patients are well served by tobacco-EHR systems that improve care. Managers can avoid sub-optimal implementation by considering several threats to effectiveness before proceeding to systems change.

scholarly journals Implementation Science to Improve Tobacco Cessation Services in Oncology Care

2021 ◽  
Vol 19 (Suppl_1) ◽  
pp. S12-S15
Author(s):  
_ _
Keyword(s):  
Implementation Science ◽  
Tobacco Use ◽  
Working Group ◽  
Tobacco Cessation ◽  
Common Interest ◽  
Evidence Based ◽  
Cancer Centers ◽  
Tobacco Treatment ◽  
Oncology Care ◽  
Science Working

Every patient with cancer deserves access to evidence-based tobacco cessation interventions as part of their routine oncology care. The NCI Cancer Moonshot funded the Cancer Center Cessation Initiative (C3I) to help establish and/or expand tobacco treatment programs at 52 NCI-designated Cancer Centers. Although this initiative has broadened the availability of tobacco treatment services across US cancer centers, the reach and utilization of these services remains low among patients. To help address the remaining gap between the availability and utilization of evidence-based treatments for tobacco use in the oncologic context, staff and investigators at C3I sites and the C3I Coordinating Center formed the C3I Implementation Science Working Group. The mission of this working group is to bring together clinicians, scientists, and policymakers who share a common interest in implementation science and treating tobacco use in the oncologic context to collaborate on projects aimed at shrinking the practice gap in this area. Through case study examples, we describe how the C3I Implementation Science Working Group is supporting efforts to identify effective ways to increase the utilization of evidence-based tobacco treatments within cancer treatment settings and promote the broader impact and long-term sustainability of C3I.

Implementation and evaluation of a tobacco cessation program in an outpatient oncology center.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 117-117
Author(s):  
Thomas A. Hensing ◽  
Bruce Brockstein ◽  
George W. Carro ◽  
Shannon Maureen Gavin
Keyword(s):  
Tobacco Use ◽  
Tobacco Cessation ◽  
Premature Death ◽  
The United States ◽  
Causal Link ◽  
Cancer Center ◽  
Tobacco Treatment ◽  
Treatment Specialist ◽  
One Year ◽  
The Impact

117 Background: Tobacco use is the leading preventable cause of premature death in the United States and has a causal link to various cancer types. Continued tobacco use after a cancer diagnosis may decrease survival, reduce treatment efficacy, prolong/increase treatment toxicity, and increase the risk for recurrence. The combination of support from trained professionals and appropriate medications increases the chances of quitting successfully. In the literature, the advice of a physician improves quit rates to about 10% and the combination of tobacco cessation medication and behavioral support can increase the rate to 20-35%. There is a lack of data on the impact of a tobacco cessation program integrated into a cancer center. The objective of this project is to implement and prospectively evaluate a tobacco cessation program in a hospital-based outpatient cancer center across three treatment sites. Methods: A multidisciplinary group at the cancer center was established to oversee the development and implementation of the program including: pharmacist training to become a certified Tobacco Treatment Specialist, electronic medical record documentation tool establishment, and development of patient education tools. The pharmacist provided one-on-one counseling for each referred patient. Assessment of the 3, 6, and 12 month quit rates was performed. Results: The tobacco cessation program at the cancer center has been available for approximately one year to all patients and their family members. Of the 67 patients referred to the tobacco cessation program, 27 (40%) patients followed through with the referral and met with the tobacco treatment specialist. The 3, 6, and 12 month quit rates are 68%, 50%, and 50%, respectively. Conclusions: The tobacco cessation program at the cancer center is evolving into a successful program. The quit rates of the program have exceeded those reported in the literature. The accessibility of the tobacco cessation program has enhanced the comprehensive care provided to the patients at the cancer center.

scholarly journals Factors associated with tobacco cessation attempts among inpatients in a psychiatric hospital

2020 ◽  
Vol 15 (2) ◽  
pp. 84-93
Author(s):  
Janet K. Otachi ◽  
Sarret Seng ◽  
Chizimuzo T. C. Okoli
Keyword(s):  
Tobacco Cessation ◽  
Smoking Initiation ◽  
Mental Illnesses ◽  
Evidence Based ◽  
Psychiatric Facility ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Factors Associated ◽  
Tobacco Treatment ◽  
Cold Turkey

AbstractIntroductionSeveral effective evidence-based tobacco treatment approaches can optimize cessation attempts; however, little is known about the utilization of such strategies by people with mental illnesses (MI) during their cessation attempts.AimsTo examine methods used during and factors associated with tobacco cessation attempts among people with MI.MethodsSelf-administered cross-sectional survey data were obtained from 132 tobacco using inpatients from a psychiatric facility in Kentucky, USA.ResultsOur study found ‘cold turkey’ as the most reported method by inpatient tobacco users with MI in their prior cessation attempts regardless of the psychiatric diagnosis category. Multivariate logistic regression found ethnicity (OR 26.1; 95% CI 2.9–237.1), age at 1st smoke (OR 1.1; 95% CI 1.0–1.1), importance to quit (OR 1.2; 95% CI 1.0–1.4), and receipt of brief tobacco treatment interventions (OR 1.1; 95% CI 1.0–1.3) significantly associated with quit attempt in the past year.ConclusionDespite the existence of various evidence-based approaches to enhance tobacco cessation among people with MI, ‘cold-turkey’ was the most preferred method in this sample. In addition, this study highlighted ethnicity, importance to quit, age at 1st smoke, and receipt of brief interventions as important factors to consider when tailoring tobacco cessation in this population. Though ethnicity is a non-modifiable factor, an informed provider may intervene skillfully by addressing socio-cultural barriers specific to an ethnic group. Lower ratings on the motivation ruler and early age of smoking initiation could also inform providers when using motivational interviewing and other evidence-based tobacco-cessation approaches.

scholarly journals AI and Big Data in Healthcare: Towards a More Comprehensive Research Framework for Multimorbidity

2021 ◽  
Vol 10 (4) ◽  
pp. 766 ◽  
Author(s):  
Ljiljana Trtica Majnarić ◽  
František Babič ◽  
Shane O’Sullivan ◽  
Andreas Holzinger
Keyword(s):  
Big Data ◽  
Clinical Decision Making ◽  
Big Data Analytics ◽  
Clinical Decision ◽  
Radical Change ◽  
Research Approach ◽  
Classification Problems ◽  
Care Needs ◽  
Healthcare Settings ◽  
Interaction Factors

Multimorbidity refers to the coexistence of two or more chronic diseases in one person. Therefore, patients with multimorbidity have multiple and special care needs. However, in practice it is difficult to meet these needs because the organizational processes of current healthcare systems tend to be tailored to a single disease. To improve clinical decision making and patient care in multimorbidity, a radical change in the problem-solving approach to medical research and treatment is needed. In addition to the traditional reductionist approach, we propose interactive research supported by artificial intelligence (AI) and advanced big data analytics. Such research approach, when applied to data routinely collected in healthcare settings, provides an integrated platform for research tasks related to multimorbidity. This may include, for example, prediction, correlation, and classification problems based on multiple interaction factors. However, to realize the idea of this paradigm shift in multimorbidity research, the optimization, standardization, and most importantly, the integration of electronic health data into a common national and international research infrastructure is needed. Ultimately, there is a need for the integration and implementation of efficient AI approaches, particularly deep learning, into clinical routine directly within the workflows of the medical professionals.

scholarly journals The Emerging Global Tobacco Treatment Workforce: Characteristics of Tobacco Treatment Specialists Trained in Council-Accredited Training Programs from 2017 to 2019

2021 ◽  
Vol 18 (5) ◽  
pp. 2416
Author(s):  
Christine E. Sheffer ◽  
Abdulmohsen Al-Zalabani ◽  
Andrée Aubrey ◽  
Rasha Bader ◽  
Claribel Beltrez ◽  
...  
Keyword(s):  
North America ◽  
Tobacco Use ◽  
Training Programs ◽  
Systems Of Care ◽  
Eastern Mediterranean ◽  
Annual Number ◽  
Treatment Services ◽  
Tobacco Treatment ◽  
The World ◽  
Academic Settings

Tobacco use is projected to kill 1 billion people in the 21st century. Tobacco Use Disorder (TUD) is one of the most common substance use disorders in the world. Evidence-based treatment of TUD is effective, but treatment accessibility remains very low. A dearth of specially trained clinicians is a significant barrier to treatment accessibility, even within systems of care that implement brief intervention models. The treatment of TUD is becoming more complex and tailoring treatment to address new and traditional tobacco products is needed. The Council for Tobacco Treatment Training Programs (Council) is the accrediting body for Tobacco Treatment Specialist (TTS) training programs. Between 2016 and 2019, n = 7761 trainees completed Council-accredited TTS training programs. Trainees were primarily from North America (92.6%) and the Eastern Mediterranean (6.1%) and were trained via in-person group workshops in medical and academic settings. From 2016 to 2019, the number of Council-accredited training programs increased from 14 to 22 and annual number of trainees increased by 28.5%. Trainees have diverse professional backgrounds and work in diverse settings but were primarily White (69.1%) and female (78.7%) located in North America. Nearly two-thirds intended to implement tobacco treatment services in their setting; two-thirds had been providing tobacco treatment for 1 year or less; and 20% were sent to training by their employers. These findings suggest that the training programs are contributing to the development of a new workforce of TTSs as well as the development of new programmatic tobacco treatment services in diverse settings. Developing strategies to support attendance from demographically and geographically diverse professionals might increase the proportion of trainees from marginalized groups and regions of the world with significant tobacco-related inequities.

scholarly journals Health workers’ perceptions on where and how to integrate tobacco use cessation services into tuberculosis treatment; a qualitative exploratory study in Uganda

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elizeus Rutebemberwa ◽  
Kellen Nyamurungi ◽  
Surabhi Joshi ◽  
Yvonne Olando ◽  
Hadii M. Mamudu ◽  
...  
Keyword(s):  
Tobacco Use ◽  
Tobacco Cessation ◽  
Health Workers ◽  
High Volume ◽  
Health Facilities ◽  
Hospital Treatment ◽  
Management Support ◽  
Tobacco Use Cessation ◽  
Tb Treatment

Abstract Background Tobacco use is associated with exacerbation of tuberculosis (TB) and poor TB treatment outcomes. Integrating tobacco use cessation within TB treatment could improve healing among TB patients. The aim was to explore perceptions of health workers on where and how to integrate tobacco use cessation services into TB treatment programs in Uganda. Methods Between March and April 2019, nine focus group discussions (FGDs) and eight key informant interviews were conducted among health workers attending to patients with tuberculosis on a routine basis in nine facilities from the central, eastern, northern and western parts of Uganda. These facilities were high volume health centres, general hospitals and referral hospitals. The FGD sessions and interviews were tape recorded, transcribed verbatim and analysed using content analysis and the Chronic Care Model as a framework. Results Respondents highlighted that just like TB prevention starts in the community and TB treatment goes beyond health facility stay, integration of tobacco cessation should be started when people are still healthy and extended to those who have been healed as they go back to communities. There was need to coordinate with different organizations like peers, the media and TB treatment supporters. TB patients needed regular follow up and self-management support for both TB and tobacco cessation. Patients needed to be empowered to know their condition and their caretakers needed to be involved. Effective referral between primary health facilities and specialist facilities was needed. Clinical information systems should identify relevant people for proactive care and follow up. In order to achieve effective integration, the health system needed to be strengthened especially health worker training and provision of more space in some of the facilities. Conclusions Tobacco cessation activities should be provided in a continuum starting in the community before the TB patients get to hospital, during the patients’ interface with hospital treatment and be given in the community after TB patients have been discharged. This requires collaboration between those who carry out health education in communities, the TB treatment supporters and the health workers who treat patients in health facilities.

scholarly journals Who are we missing with EHR-based smoking cessation treatments? A descriptive study of patients who smoke and do not regularly visit primary care clinics

2020 ◽  
Vol 15 (4) ◽  
pp. 175-180
Author(s):  
Margaret Nolan ◽  
Deejay Zwaga ◽  
Danielle McCarthy ◽  
Christian Kastman ◽  
Timothy Baker ◽  
...  
Keyword(s):  
Primary Care ◽  
Care Provider ◽  
Primary Care Provider ◽  
The United States ◽  
Primary Care Visit ◽  
Patient Portal ◽  
The Past ◽  
Healthcare Settings ◽  
Care Visit ◽  
Tobacco Treatment

AbstractIntroductionMost tobacco treatment efforts target healthcare settings, because about 75% of smokers in the United States visit a primary care provider annually. Yet, 25% of patients may be missed by such targeting.AimsTo describe patients who smoke but infrequently visit primary care – their characteristics, rates of successful telephone contact, and acceptance of tobacco treatment.MethodsTobacco Cessation Outreach Specialists ‘cold-called’ those without a primary care visit in the past year, offering tobacco dependence treatment. Age, sex, insurance status, race, ethnicity, electronic health record (EHR) patient-portal status and outreach outcomes were reported.ResultsOf 3,407 patients identified as smokers in a health system registry, 565 (16.6%) had not seen any primary care provider in the past year. Among 271 of those called, 143 (53%) were successfully reached and 33 (23%) set a quit date. Those without visits tended to be younger, male, some-day versus every-day smokers (42 vs. 44 years, P = 0.004; 48% vs. 40% female, P = 0.0002, and 21% vs. 27% some-day, P = 0.003), and less active on the EHR patient portal (33% vs. 40%, P = 0.001).ConclusionsA substantial proportion of patients who smoke are missed by traditional tobacco treatment interventions that require a primary care visit, yet many are receptive to quit smoking treatment offers.

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