The Physician-Delivered Smoking Intervention Project: factors that determine how much the physician intervenes with smokers.
OBJECTIVE
To determine factors that affect how much physicians trained to use a patient-centered smoking intervention intervene with their smoking patients.


METHODS
Forty internal medicine residents and ten internal medicine attending physicians trained in a patient-centered counseling approach were randomized to an algorithm condition (provision of intervention algorithm at each patient visit) or a no-algorithm condition. Smoking intervention steps used by physicians with patients were assessed with Patient Exit Interviews (PEIs).


METHODS
Ambulatory clinic; academic medical center.


METHODS
Five hundred twenty-seven adult smokers seen in clinic between June 1990 and April 1992.


RESULTS
There was no difference in overall PEI scores or in individual PEI steps taken between the algorithm and no-algorithm conditions. Two patient baseline factors (reporting thinking of stopping smoking within six months and higher Fagerstrom Tolerance Score) and one physician factor (older age) were significantly predictive of higher PEI score.


CONCLUSIONS
Provision of an intervention algorithm at each patient visit does not increase the likelihood that trained physicians who are cued to intervene will perform more of the intervention steps taught. Trained physicians are more likely to intervene with smokers who are more nicotine-dependent and who expect and desire to stop smoking.
Ockene
J K
JK
Department of Medicine, University of Massachusetts Medical School, Worcester.
Adams
A
A
Pbert
L
L
Luippold
R
R
Hebert
J R
JR
Quirk
M
M
Kalan
K
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D000704:Analysis of Variance; D006801:Humans; D008875:Middle Aged; D010349:Patient Compliance; D010819:Physician's Role; D010817:Physician-Patient Relations; D012044:Regression Analysis; D016540:Smoking Cessation / Q000379:methods*