Trial Outcomes & Findings for Improving Tobacco Treatment Rates for Outpatient Cancer Patients Who Smoke (NCT NCT04737031)
NCT ID: NCT04737031
Last Updated: 2024-02-13
Results Overview
Defined as the proportion of patients who received either a treatment referral (via the BPA or elsewhere in the EHR workflow) or a prescription for tobacco treatment medication (i.e., nicotine replacement, varenicline, or bupropion) Based on workflow issues and recommendations from the trial's Data and Safety Monitoring Board (DSMB), the primary outcome for this trial was adjusted to contain both referrals to TUTS and medication prescriptions.
Recruitment status
COMPLETED
Study phase
NA
Target enrollment
2146 participants
Primary outcome timeframe
through study completion, up to one year
Results posted on
2024-02-13
Participant Flow
2,146 patients were enrolled in this trial. They were seen by a total of 246 clinicians across 88 clusters. Outcome measures were collected for patients.
Unit of analysis: Clusters
Participant milestones
| Measure |
Usual Care
Clinicians and patients will receive no further interventions beyond usual practice.
|
Clinician Nudge
Clinicians will receive a nudge via Best Practice Alert within the EMR
Clinician Nudge: Investigators will use the Best Practice Alert functionality within the EMR as the conduit to the point of decision-making. Epic currently "fires" a BPA for each new patient presenting to ACC within the Medical Assistant check-in and vital sign workflow, requiring that medical assistants assess tobacco use status within the past 30 days and satisfy the alert with one of three possible answers. Upon opening the Epic Order tab at a patient's next visit after the screening encounter, clinicians will receive the implementation strategy, placed directly over the order interface. The clinician will be required to "acknowledge" or "opt-out" when presented with the order. Opting-out will require clinicians to acknowledge a reason for opt-out using a checklist or free text.
|
Patient Nudge
Patients will receive a message sent through myPennMedicine following establishment of their smoking status.
Patient Nudge: Patients will receive a message sent through myPennMedicine following establishment of their smoking status (at the screening encounter). In all cases, the message will include information specific to the upcoming appointment with the oncology clinician.
|
Clinician and Patient Nudge
Both strategies described above will be used.
Clinician Nudge: Investigators will use the Best Practice Alert functionality within the EMR as the conduit to the point of decision-making. Epic currently "fires" a BPA for each new patient presenting to ACC within the Medical Assistant check-in and vital sign workflow, requiring that medical assistants assess tobacco use status within the past 30 days and satisfy the alert with one of three possible answers. Upon opening the Epic Order tab at a patient's next visit after the screening encounter, clinicians will receive the implementation strategy, placed directly over the order interface. The clinician will be required to "acknowledge" or "opt-out" when presented with the order. Opting-out will require clinicians to acknowledge a reason for opt-out using a checklist or free text.
Patient Nudge: Patients will receive a message sent through myPennMedicine following establishment of their smoking status (at the screening encounter). In all cases, the message will include information specific to the upcoming appointment with the oncology clinician.
|
|---|---|---|---|---|
|
Overall Study
STARTED
|
490 22
|
506 24
|
405 19
|
745 23
|
|
Overall Study
COMPLETED
|
490 22
|
475 24
|
312 19
|
518 23
|
|
Overall Study
NOT COMPLETED
|
0 0
|
31 0
|
93 0
|
227 0
|
Reasons for withdrawal
| Measure |
Usual Care
Clinicians and patients will receive no further interventions beyond usual practice.
|
Clinician Nudge
Clinicians will receive a nudge via Best Practice Alert within the EMR
Clinician Nudge: Investigators will use the Best Practice Alert functionality within the EMR as the conduit to the point of decision-making. Epic currently "fires" a BPA for each new patient presenting to ACC within the Medical Assistant check-in and vital sign workflow, requiring that medical assistants assess tobacco use status within the past 30 days and satisfy the alert with one of three possible answers. Upon opening the Epic Order tab at a patient's next visit after the screening encounter, clinicians will receive the implementation strategy, placed directly over the order interface. The clinician will be required to "acknowledge" or "opt-out" when presented with the order. Opting-out will require clinicians to acknowledge a reason for opt-out using a checklist or free text.
|
Patient Nudge
Patients will receive a message sent through myPennMedicine following establishment of their smoking status.
Patient Nudge: Patients will receive a message sent through myPennMedicine following establishment of their smoking status (at the screening encounter). In all cases, the message will include information specific to the upcoming appointment with the oncology clinician.
|
Clinician and Patient Nudge
Both strategies described above will be used.
Clinician Nudge: Investigators will use the Best Practice Alert functionality within the EMR as the conduit to the point of decision-making. Epic currently "fires" a BPA for each new patient presenting to ACC within the Medical Assistant check-in and vital sign workflow, requiring that medical assistants assess tobacco use status within the past 30 days and satisfy the alert with one of three possible answers. Upon opening the Epic Order tab at a patient's next visit after the screening encounter, clinicians will receive the implementation strategy, placed directly over the order interface. The clinician will be required to "acknowledge" or "opt-out" when presented with the order. Opting-out will require clinicians to acknowledge a reason for opt-out using a checklist or free text.
Patient Nudge: Patients will receive a message sent through myPennMedicine following establishment of their smoking status (at the screening encounter). In all cases, the message will include information specific to the upcoming appointment with the oncology clinician.
|
|---|---|---|---|---|
|
Overall Study
Patients who did not have a treatment visit
|
0
|
31
|
93
|
227
|
Baseline Characteristics
Improving Tobacco Treatment Rates for Outpatient Cancer Patients Who Smoke
Baseline characteristics by cohort
| Measure |
Clinician Nudge
n=506 Participants
Clinicians will receive a nudge via Best Practice Alert within the EMR
Clinician Nudge: Investigators will use the Best Practice Alert functionality within the EMR as the conduit to the point of decision-making. Epic currently "fires" a BPA for each new patient presenting to ACC within the Medical Assistant check-in and vital sign workflow, requiring that medical assistants assess tobacco use status within the past 30 days and satisfy the alert with one of three possible answers. Upon opening the Epic Order tab at a patient's next visit after the screening encounter, clinicians will receive the implementation strategy, placed directly over the order interface. The clinician will be required to "acknowledge" or "opt-out" when presented with the order. Opting-out will require clinicians to acknowledge a reason for opt-out using a checklist or free text.
|
Patient Nudge
n=405 Participants
Patients will receive a message sent through myPennMedicine following establishment of their smoking status.
Patient Nudge: Patients will receive a message sent through myPennMedicine following establishment of their smoking status (at the screening encounter). In all cases, the message will include information specific to the upcoming appointment with the oncology clinician.
|
Usual Care
n=490 Participants
Clinicians and patients will receive no further interventions beyond usual practice.
|
Clinician and Patient Nudge
n=745 Participants
Both strategies described above will be used.
Clinician Nudge: Investigators will use the Best Practice Alert functionality within the EMR as the conduit to the point of decision-making. Epic currently "fires" a BPA for each new patient presenting to ACC within the Medical Assistant check-in and vital sign workflow, requiring that medical assistants assess tobacco use status within the past 30 days and satisfy the alert with one of three possible answers. Upon opening the Epic Order tab at a patient's next visit after the screening encounter, clinicians will receive the implementation strategy, placed directly over the order interface. The clinician will be required to "acknowledge" or "opt-out" when presented with the order. Opting-out will require clinicians to acknowledge a reason for opt-out using a checklist or free text.
Patient Nudge: Patients will receive a message sent through myPennMedicine following establishment of their smoking status (at the screening encounter). In all cases, the message will include information specific to the upcoming appointment with the oncology clinician.
|
Total
n=2146 Participants
Total of all reporting groups
|
|---|---|---|---|---|---|
|
Age, Continuous
|
61.2 years
STANDARD_DEVIATION 12.6 • n=7 Participants
|
62.8 years
STANDARD_DEVIATION 11.7 • n=5 Participants
|
61.9 years
STANDARD_DEVIATION 12.7 • n=5 Participants
|
60.7 years
STANDARD_DEVIATION 12.6 • n=4 Participants
|
61.5 years
STANDARD_DEVIATION 12.5 • n=21 Participants
|
|
Sex: Female, Male
Female
|
274 Participants
n=7 Participants
|
164 Participants
n=5 Participants
|
238 Participants
n=5 Participants
|
327 Participants
n=4 Participants
|
1003 Participants
n=21 Participants
|
|
Sex: Female, Male
Male
|
232 Participants
n=7 Participants
|
241 Participants
n=5 Participants
|
252 Participants
n=5 Participants
|
418 Participants
n=4 Participants
|
1143 Participants
n=21 Participants
|
|
Ethnicity (NIH/OMB)
Hispanic or Latino
|
10 Participants
n=7 Participants
|
5 Participants
n=5 Participants
|
4 Participants
n=5 Participants
|
26 Participants
n=4 Participants
|
45 Participants
n=21 Participants
|
|
Ethnicity (NIH/OMB)
Not Hispanic or Latino
|
496 Participants
n=7 Participants
|
400 Participants
n=5 Participants
|
486 Participants
n=5 Participants
|
718 Participants
n=4 Participants
|
2100 Participants
n=21 Participants
|
|
Ethnicity (NIH/OMB)
Unknown or Not Reported
|
0 Participants
n=7 Participants
|
0 Participants
n=5 Participants
|
0 Participants
n=5 Participants
|
1 Participants
n=4 Participants
|
1 Participants
n=21 Participants
|
|
Race (NIH/OMB)
American Indian or Alaska Native
|
0 Participants
n=7 Participants
|
0 Participants
n=5 Participants
|
2 Participants
n=5 Participants
|
0 Participants
n=4 Participants
|
2 Participants
n=21 Participants
|
|
Race (NIH/OMB)
Asian
|
8 Participants
n=7 Participants
|
3 Participants
n=5 Participants
|
6 Participants
n=5 Participants
|
12 Participants
n=4 Participants
|
29 Participants
n=21 Participants
|
|
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
|
2 Participants
n=7 Participants
|
1 Participants
n=5 Participants
|
0 Participants
n=5 Participants
|
0 Participants
n=4 Participants
|
3 Participants
n=21 Participants
|
|
Race (NIH/OMB)
Black or African American
|
151 Participants
n=7 Participants
|
86 Participants
n=5 Participants
|
114 Participants
n=5 Participants
|
200 Participants
n=4 Participants
|
551 Participants
n=21 Participants
|
|
Race (NIH/OMB)
White
|
318 Participants
n=7 Participants
|
283 Participants
n=5 Participants
|
333 Participants
n=5 Participants
|
488 Participants
n=4 Participants
|
1422 Participants
n=21 Participants
|
|
Race (NIH/OMB)
More than one race
|
2 Participants
n=7 Participants
|
5 Participants
n=5 Participants
|
4 Participants
n=5 Participants
|
5 Participants
n=4 Participants
|
16 Participants
n=21 Participants
|
|
Race (NIH/OMB)
Unknown or Not Reported
|
25 Participants
n=7 Participants
|
27 Participants
n=5 Participants
|
31 Participants
n=5 Participants
|
40 Participants
n=4 Participants
|
123 Participants
n=21 Participants
|
|
Region of Enrollment
United States
|
506 participants
n=7 Participants
|
405 participants
n=5 Participants
|
490 participants
n=5 Participants
|
745 participants
n=4 Participants
|
2146 participants
n=21 Participants
|
|
Marital Status
Single
|
244 Participants
n=7 Participants
|
199 Participants
n=5 Participants
|
248 Participants
n=5 Participants
|
432 Participants
n=4 Participants
|
1123 Participants
n=21 Participants
|
|
Marital Status
Other
|
262 Participants
n=7 Participants
|
206 Participants
n=5 Participants
|
242 Participants
n=5 Participants
|
313 Participants
n=4 Participants
|
1023 Participants
n=21 Participants
|
|
Clinician Type (seen by patients)
Advanced Practice Provider (APP)
|
136 Participants
n=7 Participants
|
140 Participants
n=5 Participants
|
130 Participants
n=5 Participants
|
136 Participants
n=4 Participants
|
542 Participants
n=21 Participants
|
|
Clinician Type (seen by patients)
Physician
|
370 Participants
n=7 Participants
|
265 Participants
n=5 Participants
|
360 Participants
n=5 Participants
|
609 Participants
n=4 Participants
|
1604 Participants
n=21 Participants
|
|
Clinician Specialty (seen by patients)
Gynecologic oncology
|
21 Participants
n=7 Participants
|
11 Participants
n=5 Participants
|
8 Participants
n=5 Participants
|
0 Participants
n=4 Participants
|
40 Participants
n=21 Participants
|
|
Clinician Specialty (seen by patients)
Hematologic oncology
|
402 Participants
n=7 Participants
|
358 Participants
n=5 Participants
|
388 Participants
n=5 Participants
|
604 Participants
n=4 Participants
|
1752 Participants
n=21 Participants
|
|
Clinician Specialty (seen by patients)
Radiology oncology
|
83 Participants
n=7 Participants
|
36 Participants
n=5 Participants
|
94 Participants
n=5 Participants
|
141 Participants
n=4 Participants
|
354 Participants
n=21 Participants
|
|
Days between arm assignment and engagement
|
73.42 days
STANDARD_DEVIATION 76.1 • n=7 Participants
|
64.84 days
STANDARD_DEVIATION 66.4 • n=5 Participants
|
68.16 days
STANDARD_DEVIATION 69.9 • n=5 Participants
|
72.00 days
STANDARD_DEVIATION 71.7 • n=4 Participants
|
70.10 days
STANDARD_DEVIATION 71.40 • n=21 Participants
|
PRIMARY outcome
Timeframe: through study completion, up to one yearPopulation: Outcome measures were not collected for clinicians.
Defined as the proportion of patients who received either a treatment referral (via the BPA or elsewhere in the EHR workflow) or a prescription for tobacco treatment medication (i.e., nicotine replacement, varenicline, or bupropion) Based on workflow issues and recommendations from the trial's Data and Safety Monitoring Board (DSMB), the primary outcome for this trial was adjusted to contain both referrals to TUTS and medication prescriptions.
Outcome measures
| Measure |
Usual Care
n=490 Participants
Clinicians and patients will receive no further interventions beyond usual practice.
|
Clinician Nudge
n=506 Participants
Clinicians will receive a nudge via Best Practice Alert within the EMR
Clinician Nudge: Investigators will use the Best Practice Alert functionality within the EMR as the conduit to the point of decision-making. Epic currently "fires" a BPA for each new patient presenting to ACC within the Medical Assistant check-in and vital sign workflow, requiring that medical assistants assess tobacco use status within the past 30 days and satisfy the alert with one of three possible answers. Upon opening the Epic Order tab at a patient's next visit after the screening encounter, clinicians will receive the implementation strategy, placed directly over the order interface. The clinician will be required to "acknowledge" or "opt-out" when presented with the order. Opting-out will require clinicians to acknowledge a reason for opt-out using a checklist or free text.
|
Patient Nudge
n=405 Participants
Patients will receive a message sent through myPennMedicine following establishment of their smoking status.
Patient Nudge: Patients will receive a message sent through myPennMedicine following establishment of their smoking status (at the screening encounter). In all cases, the message will include information specific to the upcoming appointment with the oncology clinician.
|
Clinician and Patient Nudge
n=745 Participants
Both strategies described above will be used.
Clinician Nudge: Investigators will use the Best Practice Alert functionality within the EMR as the conduit to the point of decision-making. Epic currently "fires" a BPA for each new patient presenting to ACC within the Medical Assistant check-in and vital sign workflow, requiring that medical assistants assess tobacco use status within the past 30 days and satisfy the alert with one of three possible answers. Upon opening the Epic Order tab at a patient's next visit after the screening encounter, clinicians will receive the implementation strategy, placed directly over the order interface. The clinician will be required to "acknowledge" or "opt-out" when presented with the order. Opting-out will require clinicians to acknowledge a reason for opt-out using a checklist or free text.
Patient Nudge: Patients will receive a message sent through myPennMedicine following establishment of their smoking status (at the screening encounter). In all cases, the message will include information specific to the upcoming appointment with the oncology clinician.
|
|---|---|---|---|---|
|
Penetration (Rate of Referral to TUTS or Medication Prescription)
|
66 Participants
|
180 Participants
|
40 Participants
|
222 Participants
|
SECONDARY outcome
Timeframe: Up to 30 days following baselinePopulation: This outcome was only assessed for patients who were referred to TUTS. Outcome measures were not collected for clinicians.
Defined as the number of patients who make a pharmacologically-assisted quit attempt using any of the seven pharmacotherapies within 30 days of the initial oncology visit, divided by the total number of referred patients
Outcome measures
| Measure |
Usual Care
n=66 Participants
Clinicians and patients will receive no further interventions beyond usual practice.
|
Clinician Nudge
n=180 Participants
Clinicians will receive a nudge via Best Practice Alert within the EMR
Clinician Nudge: Investigators will use the Best Practice Alert functionality within the EMR as the conduit to the point of decision-making. Epic currently "fires" a BPA for each new patient presenting to ACC within the Medical Assistant check-in and vital sign workflow, requiring that medical assistants assess tobacco use status within the past 30 days and satisfy the alert with one of three possible answers. Upon opening the Epic Order tab at a patient's next visit after the screening encounter, clinicians will receive the implementation strategy, placed directly over the order interface. The clinician will be required to "acknowledge" or "opt-out" when presented with the order. Opting-out will require clinicians to acknowledge a reason for opt-out using a checklist or free text.
|
Patient Nudge
n=40 Participants
Patients will receive a message sent through myPennMedicine following establishment of their smoking status.
Patient Nudge: Patients will receive a message sent through myPennMedicine following establishment of their smoking status (at the screening encounter). In all cases, the message will include information specific to the upcoming appointment with the oncology clinician.
|
Clinician and Patient Nudge
n=222 Participants
Both strategies described above will be used.
Clinician Nudge: Investigators will use the Best Practice Alert functionality within the EMR as the conduit to the point of decision-making. Epic currently "fires" a BPA for each new patient presenting to ACC within the Medical Assistant check-in and vital sign workflow, requiring that medical assistants assess tobacco use status within the past 30 days and satisfy the alert with one of three possible answers. Upon opening the Epic Order tab at a patient's next visit after the screening encounter, clinicians will receive the implementation strategy, placed directly over the order interface. The clinician will be required to "acknowledge" or "opt-out" when presented with the order. Opting-out will require clinicians to acknowledge a reason for opt-out using a checklist or free text.
Patient Nudge: Patients will receive a message sent through myPennMedicine following establishment of their smoking status (at the screening encounter). In all cases, the message will include information specific to the upcoming appointment with the oncology clinician.
|
|---|---|---|---|---|
|
Treatment Engagement Rates (Medication)
|
52 Participants
|
66 Participants
|
28 Participants
|
88 Participants
|
SECONDARY outcome
Timeframe: Up to 90 days after Repeat VisitPopulation: This outcome was only assessed for patients who were referred to TUTS. Outcome measures were not collected for clinicians.
Defined as the number of patients who receive a quit-line referral or in-person or telephone cessation counseling, divided by the total number of TUTS-engaged patients
Outcome measures
| Measure |
Usual Care
n=66 Participants
Clinicians and patients will receive no further interventions beyond usual practice.
|
Clinician Nudge
n=180 Participants
Clinicians will receive a nudge via Best Practice Alert within the EMR
Clinician Nudge: Investigators will use the Best Practice Alert functionality within the EMR as the conduit to the point of decision-making. Epic currently "fires" a BPA for each new patient presenting to ACC within the Medical Assistant check-in and vital sign workflow, requiring that medical assistants assess tobacco use status within the past 30 days and satisfy the alert with one of three possible answers. Upon opening the Epic Order tab at a patient's next visit after the screening encounter, clinicians will receive the implementation strategy, placed directly over the order interface. The clinician will be required to "acknowledge" or "opt-out" when presented with the order. Opting-out will require clinicians to acknowledge a reason for opt-out using a checklist or free text.
|
Patient Nudge
n=40 Participants
Patients will receive a message sent through myPennMedicine following establishment of their smoking status.
Patient Nudge: Patients will receive a message sent through myPennMedicine following establishment of their smoking status (at the screening encounter). In all cases, the message will include information specific to the upcoming appointment with the oncology clinician.
|
Clinician and Patient Nudge
n=222 Participants
Both strategies described above will be used.
Clinician Nudge: Investigators will use the Best Practice Alert functionality within the EMR as the conduit to the point of decision-making. Epic currently "fires" a BPA for each new patient presenting to ACC within the Medical Assistant check-in and vital sign workflow, requiring that medical assistants assess tobacco use status within the past 30 days and satisfy the alert with one of three possible answers. Upon opening the Epic Order tab at a patient's next visit after the screening encounter, clinicians will receive the implementation strategy, placed directly over the order interface. The clinician will be required to "acknowledge" or "opt-out" when presented with the order. Opting-out will require clinicians to acknowledge a reason for opt-out using a checklist or free text.
Patient Nudge: Patients will receive a message sent through myPennMedicine following establishment of their smoking status (at the screening encounter). In all cases, the message will include information specific to the upcoming appointment with the oncology clinician.
|
|---|---|---|---|---|
|
Treatment Engagement Rate (Behavioral)
|
0 Participants
|
131 Participants
|
0 Participants
|
133 Participants
|
SECONDARY outcome
Timeframe: Up to 90 days after Repeat VisitPopulation: This outcome was assessed for patients with whom TUTS staff were able to successfully follow up. Outcome measures were not collected for clinicians.
Defined as the number of TUTS-referred patients who make any quit attempt, divided by the total number of TUTS-referred patients
Outcome measures
| Measure |
Usual Care
Clinicians and patients will receive no further interventions beyond usual practice.
|
Clinician Nudge
n=18 Participants
Clinicians will receive a nudge via Best Practice Alert within the EMR
Clinician Nudge: Investigators will use the Best Practice Alert functionality within the EMR as the conduit to the point of decision-making. Epic currently "fires" a BPA for each new patient presenting to ACC within the Medical Assistant check-in and vital sign workflow, requiring that medical assistants assess tobacco use status within the past 30 days and satisfy the alert with one of three possible answers. Upon opening the Epic Order tab at a patient's next visit after the screening encounter, clinicians will receive the implementation strategy, placed directly over the order interface. The clinician will be required to "acknowledge" or "opt-out" when presented with the order. Opting-out will require clinicians to acknowledge a reason for opt-out using a checklist or free text.
|
Patient Nudge
Patients will receive a message sent through myPennMedicine following establishment of their smoking status.
Patient Nudge: Patients will receive a message sent through myPennMedicine following establishment of their smoking status (at the screening encounter). In all cases, the message will include information specific to the upcoming appointment with the oncology clinician.
|
Clinician and Patient Nudge
n=24 Participants
Both strategies described above will be used.
Clinician Nudge: Investigators will use the Best Practice Alert functionality within the EMR as the conduit to the point of decision-making. Epic currently "fires" a BPA for each new patient presenting to ACC within the Medical Assistant check-in and vital sign workflow, requiring that medical assistants assess tobacco use status within the past 30 days and satisfy the alert with one of three possible answers. Upon opening the Epic Order tab at a patient's next visit after the screening encounter, clinicians will receive the implementation strategy, placed directly over the order interface. The clinician will be required to "acknowledge" or "opt-out" when presented with the order. Opting-out will require clinicians to acknowledge a reason for opt-out using a checklist or free text.
Patient Nudge: Patients will receive a message sent through myPennMedicine following establishment of their smoking status (at the screening encounter). In all cases, the message will include information specific to the upcoming appointment with the oncology clinician.
|
|---|---|---|---|---|
|
Quit Attempt Rate
|
0 Participants
|
14 Participants
|
0 Participants
|
18 Participants
|
SECONDARY outcome
Timeframe: Up to 90 days after Repeat VisitPopulation: This outcome was assessed for patients with whom TUTS staff were able to successfully follow up. Outcome measures were not collected for clinicians.
Defined as the total number of TUTS-referred patients self-reporting 7-day point prevalence abstinence at a 90-day follow-up assessment, divided by the total number of TUTS-referred patients
Outcome measures
| Measure |
Usual Care
Clinicians and patients will receive no further interventions beyond usual practice.
|
Clinician Nudge
n=18 Participants
Clinicians will receive a nudge via Best Practice Alert within the EMR
Clinician Nudge: Investigators will use the Best Practice Alert functionality within the EMR as the conduit to the point of decision-making. Epic currently "fires" a BPA for each new patient presenting to ACC within the Medical Assistant check-in and vital sign workflow, requiring that medical assistants assess tobacco use status within the past 30 days and satisfy the alert with one of three possible answers. Upon opening the Epic Order tab at a patient's next visit after the screening encounter, clinicians will receive the implementation strategy, placed directly over the order interface. The clinician will be required to "acknowledge" or "opt-out" when presented with the order. Opting-out will require clinicians to acknowledge a reason for opt-out using a checklist or free text.
|
Patient Nudge
Patients will receive a message sent through myPennMedicine following establishment of their smoking status.
Patient Nudge: Patients will receive a message sent through myPennMedicine following establishment of their smoking status (at the screening encounter). In all cases, the message will include information specific to the upcoming appointment with the oncology clinician.
|
Clinician and Patient Nudge
n=24 Participants
Both strategies described above will be used.
Clinician Nudge: Investigators will use the Best Practice Alert functionality within the EMR as the conduit to the point of decision-making. Epic currently "fires" a BPA for each new patient presenting to ACC within the Medical Assistant check-in and vital sign workflow, requiring that medical assistants assess tobacco use status within the past 30 days and satisfy the alert with one of three possible answers. Upon opening the Epic Order tab at a patient's next visit after the screening encounter, clinicians will receive the implementation strategy, placed directly over the order interface. The clinician will be required to "acknowledge" or "opt-out" when presented with the order. Opting-out will require clinicians to acknowledge a reason for opt-out using a checklist or free text.
Patient Nudge: Patients will receive a message sent through myPennMedicine following establishment of their smoking status (at the screening encounter). In all cases, the message will include information specific to the upcoming appointment with the oncology clinician.
|
|---|---|---|---|---|
|
Abstinence Rate
|
0 Participants
|
2 Participants
|
0 Participants
|
1 Participants
|
Adverse Events
Usual Care
Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths
Clinician Nudge
Serious events: 0 serious events
Other events: 0 other events
Deaths: 1 deaths
Patient Nudge
Serious events: 0 serious events
Other events: 0 other events
Deaths: 5 deaths
Clinician and Patient Nudge
Serious events: 0 serious events
Other events: 0 other events
Deaths: 18 deaths
Serious adverse events
Adverse event data not reported
Other adverse events
Adverse event data not reported
Additional Information
Results disclosure agreements
- Principal investigator is a sponsor employee
- Publication restrictions are in place