Primary Care Physicians' Use of Stop-Smoking Plans to Help Patients Who Are Smokers
NCT ID: NCT00227786
Last Updated: 2013-08-16
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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COMPLETED
NA
344 participants
INTERVENTIONAL
2003-01-31
2006-05-31
Brief Summary
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PURPOSE: This randomized clinical trial is studying physicians' practice patterns to see if regular feedback to the physician increases the chance of adult smokers receiving stop-smoking treatment.
Detailed Description
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* Develop an automated coding system using existing electronic medical records (EMRs) to assess adherence to national tobacco-cessation treatment guidelines by individual physicians in the primary care setting at 4 health maintenance organizations.
* Compare the validity of the automated coding system with that of coding performed by medical record abstractors.
* Determine the effect of performance feedback on tobacco treatment practice patterns over 2 years among primary care physicians.
* Provide recommendations for recording tobacco-cessation treatment services in EMR systems and evaluating adherence to treatment guidelines.
* Produce a set of computer programs that can be easily adopted in diverse health care settings for assessing adherence to the national tobacco-cessation treatment guidelines using data from EMRs.
OUTLINE: This is a randomized, controlled, multicenter study. Physicians from each participating center are sorted into pairs according to their rate of providing advice to quit smoking to identified adult smokers and the number of identified adult smokers seen in the 3-month baseline observation period. Each physician in the pair is then randomized to 1 of 2 arms.
* Arm I (automated coding system feedback): Physicians receive reports from an automated coding system regarding their performance in administering tobacco-cessation services in each of the five A's (Ask, Advise, Assess, Assist, and Arrange) to identified smokers in comparison with their past performance and in comparison with their anonymous colleagues once every 3 months. One year after randomization, these physicians are further randomized, using the same paired-group approach, to either continue receiving automated coding system feedback for 1 additional year OR to stop receiving feedback.
Physicians receive a survey at the end of 2-year period regarding the usefulness of each aspect of the feedback reports and the feedback program in general.
* Arm II (control): Physicians do not receive any information regarding their performance in administering tobacco-cessation services in each of the five A's to identified smokers.
A questionnaire about tobacco-cessation services in primary care is sent to patients of all physicians within two weeks of each patient's primary care visit and then at the end of the first year of providing feedback to physicians to compare patient report of tobacco-cessation services with what is documented in the electronic medical record for that primary care visit.
PROJECTED ACCRUAL: At least 40 primary care physicians per participating center and 1,000 patients (250 per participating center) will be accrued for this study.
Conditions
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Keywords
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Study Design
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RANDOMIZED
SINGLE_GROUP
PREVENTION
SINGLE
Interventions
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smoking cessation intervention
counseling intervention
Eligibility Criteria
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Inclusion Criteria
* Primary care physician, meeting all of the following criteria:
* Practicing medicine in a family practice or internal medicine clinic
* Scheduled to see adult primary care patients for ≥ 2½ days (or 5 half days or equivalent combination of full and half days) per week
* Planning to continue full-time practice in their participating organization for at least the next 2 years
* At least 1 year of experience working with the local electronic medical record system
* Patient
* Adult smoker who visited a study physician within the past month
PATIENT CHARACTERISTICS:
Age
* Adult
Performance status
* Not specified
Life expectancy
* Not specified
Hematopoietic
* Not specified
Hepatic
* Not specified
Renal
* Not specified
PRIOR CONCURRENT THERAPY:
Biologic therapy
* Not specified
Chemotherapy
* Not specified
Endocrine therapy
* Not specified
Radiotherapy
* Not specified
Surgery
* Not specified
18 Years
ALL
No
Sponsors
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Kaiser Permanente
OTHER
Responsible Party
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Principal Investigators
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Victor J. Stevens, PhD
Role: STUDY_CHAIR
Kaiser Permanente
Locations
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Kaiser Permanente - Aurora
Aurora, Colorado, United States
Kaiser Permanente Center for Health Research - Hawaii
Honolulu, Hawaii, United States
Massachusetts General Hospital Cancer Center
Boston, Massachusetts, United States
Harvard Pilgrim Health Care
Boston, Massachusetts, United States
Kaiser Permanente Center for Health Research
Portland, Oregon, United States
Countries
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Other Identifiers
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KAISER-U19-CA099193
Identifier Type: -
Identifier Source: secondary_id
CDR0000448865
Identifier Type: -
Identifier Source: org_study_id