2609 Randomized Clinical Trial: Computer-Assisted Tool for Tobacco Dependence Interventions

Friday, March 18, 2011: 3:30 p.m. - 4:45 p.m.
Location: Hall C (San Diego Convention Center)
Presentation Type: Poster Session
W.A. RUSH1, T. SCHLEYER2, M. KIRSHNER3, R. BOYLE4, T. THYVALIKAKATH2, H. SPALLEK2, M.J. THOELE5, S. ASCHE6, E. DURAND6, C. ENSTAD6, C. HUNTLEY6, and D.B. RINDAL7, 1Research, HealthPartners, Minneapolis, MN, 2School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, 3Oregon Institute of Technology, Klamath Falls, OR, 4ClearWay Minnesota, Bloomington, MN, 5HealthPartner Research Foundation, Minneapolis, MN, 6HealthPartner Research Foundation, Bloomington, MN, 7Research Foundation, HealthPartners, Minneapolis, MN
OBJECTIVES: Dental providers play a potentially important role in supporting patients' tobacco cessation efforts. Despite impacts to patients' oral health, busy dental practices cite difficulty implementing dental-initiated cessation activities due to limited staff time and knowledge of suitable quit strategies. Approaches that involve Screening for drug use, Brief Intervention, and Referral to Treatment (SBIRT) provide a promising, practical solution. If designed strategically, electronic dental records (EDR) can potentially empower dental providers to incorporate tobacco interventions into clinical practice. METHODS: We report outcomes from two related studies. The first involved observations of provider utilization of an EDR system and focus groups data on clinicians' attitudes towards the use of EDRs in initiating tobacco cessation interventions with patients. The second study involves applying what was learned to the design of a SBIRT-based support tool that prompts and assists dental providers to conduct personalized cessation interventions with current tobacco users. The latter study is a blocked, group-randomized trial in the HealthPartners Dental Group clinics evaluating whether clinics utilizing computer-assisted tools in the EDR have higher rates of assessing interest in quitting tobacco use, providing a brief cessation intervention, and referring patients to treatment for cessation assistance. Telephone surveys will evaluate patients' perceived value of the intervention. RESULTS: Observation of dental exam encounters found that while the EDR health history has several fields for collecting current data on smoking status, these fields were rarely updated. Focus groups identified the provider's inability to easily record the specifics around intervention activities and maintain a record of ongoing progress as barriers. This resulted in a redesign of the tobacco section of the health history. CONCLUSIONS: The main outcome of this study was the development of a brief intervention that doesn't disrupt workflow. It provides actionable recommendations and helps the provider to maintain ongoing documentation. (NIDCR 1R21DE017325-0LA1, 1RC1DE020295-01)

Keywords: Information Technology and Tobacco