title: Fax referrals, academic detailing, and tobacco quitline use: a randomized trial.
abstract: BACKGROUND
  Fax referral programs quickly and economically can link smokers' visiting primary care clinics to state-based telephone quitlines. Yet, it is unclear how to optimize use of this strategy.
  
  
  OBJECTIVE
  To evaluate the potential of enhanced academic detailing in clinics (i.e., on-site training, technical assistance, and performance feedback) to boost utilization of a fax referral program called Fax to Quit.
  
  
  METHODS
  Participants were randomized to one of two intervention conditions.
  
  
  METHODS
  Participants were drawn from 49 primary care clinics in southeastern Wisconsin. The sample size was based on a power analysis in which the control intervention condition was estimated to generate 0.5 referrals/clinic/month and the experimental condition 2.0 referrals/clinic/month.
  
  
  METHODS
  One of two fax referral program interventions was administered: the control condition Fax to Quit-Only (F2Q-Only) or the experimental condition Fax to Quit plus Enhanced Academic Detailing (F2Q+EAD).
  
  
  METHODS
  Clinic- and clinician-specific referral and quality referral rates (those resulting in quitline enrollment) were measured for 13 months post-intervention, starting in March 2009.
  
  
  RESULTS
  Mean number of post-intervention referrals/clinician to the Wisconsin Tobacco Quitline was 5.6 times greater for F2Q+EAD (8.5, SD=7.0) compared to F2Q-Only (1.6, SD=3.6, p<0.001). The F2Q+EAD (4.8, SD=4.1) condition produced a greater mean number of quality referrals/clinician than did the F2Q-Only (0.86, SD=1.8, p<0.001) condition. Data were analyzed in 2010.
  
  
  CONCLUSIONS
  Enhanced academic detailing, which included on-site training, technical assistance, and performance feedback, increased the number of referrals more than fivefold over a fax referral program implemented without such enhanced academic detailing.
  
  
  BACKGROUND
  This study is registered at Clinicaltrials.gov NCT00989755.
authors.affiliation: Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA. megan.sheffer@aurora.org
authors.forename: Megan A
authors.initials: MA
authors.lastname: Sheffer
authors.forename: Timothy B
authors.initials: TB
authors.lastname: Baker
authors.forename: David L
authors.initials: DL
authors.lastname: Fraser
authors.forename: Robert T
authors.initials: RT
authors.lastname: Adsit
authors.forename: Timothy A
authors.initials: TA
authors.lastname: McAfee
authors.forename: Michael C
authors.initials: MC
authors.lastname: Fiore
mesh_terms: D000553:Ambulatory Care / Q000458:organization & administration; D015277:Hotlines; D006801:Humans; D011320:Primary Health Care / Q000458:organization & administration*; D011787:Quality of Health Care; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D016636:Telefacsimile; D014029:Tobacco Use Disorder / Q000534:rehabilitation*; D014922:Wisconsin