Smoking status recording in GP electronic records: the unrealised potential.
OBJECTIVE
To investigate the recording of smoking status and factors associated with the recording of smoking status in general practitioner (GP) electronic medical records (EMRs) in New Zealand, and the suitability of this source as a prevalence measure.


METHODS
General practices affiliated with an Auckland-based primary health organisation.


METHODS
Patients registered with 84/107 (78.5%) eligible GPs who had used EMRs for at least a year and had PREDICT-CVD, a web-based cardiovascular disease risk assessment and management decision support program, integrated with their practice software.


METHODS
Audit of EMRs using data from an evaluation of PREDICT-CVD.


METHODS
The proportion of EMRs audited (Maori, non-Maori) with smoking status recorded and, among those with smoking status recorded, also Read-coded, and factors associated with greater recording of smoking status.


RESULTS
Smoking status was recorded among 49.6% of Maori and 38.3% of non-Maori prior to the installation of PREDICT-CVD. Among those with smoking status recorded, smoking status was also Read-coded among 49.8% of Maori and 62.3% of non-Maori. Factors associated with greater recording of smoking status were installation of PREDICT-CVD, male sex, Maori ethnicity, cardiovascular disease and diabetes. Age was also associated with the recording of smoking status.


CONCLUSIONS
General practitioner electronic medical records in New Zealand are currently not a suitable source of smoking prevalence data, even if manually searched, as a large proportion of records did not have smoking status recorded. Such records are an even less suitable source of smoking prevalence if data extraction by remote querying (using Read codes) is relied upon. The potential to estimate the prevalence of smoking from GP records has not yet become a reality. Installation of electronic decision support systems, such as PREDICT-CVD, could improve the recording and Read-coding of smoking status, and thereby the availability and accessibility of these data.
Selak
Vanessa
V
Clinical Trials Research Unit, The University of Auckland, New Zealand. v.selak@ctru.auckland.ac.nz
Wells
Susan
S
Whittaker
Robyn
R
Stewart
Alistair
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008485:Medical Audit; D016347:Medical Records Systems, Computerized; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D010821:Physicians, Family; D012907:Smoking / Q000453:epidemiology*