Patient care outcomes of a tobacco use registry in an academic family practice.
OBJECTIVE
While the potential benefit of a chronic disease registry for tobacco use is great, outcome reports have not been generated. We examined the effect of implementing a tobacco use registry, including a decision support tool, on treatment outcomes within an academic family medicine clinic.


METHODS
A chart review of 200 patients who smoked and attended the clinic before and after registry implementation assessed the number of patients with clinic notes documenting (1) counseling for tobacco use, (2) recommendations for cessation medication, (3) a set quit date, (4) referrals to the on-site Nicotine Dependence Program (NDP) and/or QuitlineNC, and (5) pneumococcal vaccine. Data from the NDP, QuitlineNC, and clinic billing records before and after implementation compared the number of clinic-generated QuitlineNC fax referrals, new scheduled appointments for the NDP, and visits coded for tobacco counseling reimbursement.


RESULTS
Significant increases in documentation occurred across most chart review variables. Significant increases in the number of clinic-generated fax referrals to QuitlineNC (from 27 to 96), initial scheduled appointments for the NDP (from 84 to 148), and coding for tobacco counseling (from 101 to 287) also occurred when compared with total patient visits during the same time periods. Patient attendance at the NDP (52%) and acceptance of QuitlineNC services (31%) remained constant.


CONCLUSIONS
The tobacco use registry's decision support tool increased evidenced-based tobacco use treatment (referrals, medications, and counseling) for patients at an academic family medicine clinic. This novel tool offers standardized care for all patients who use tobacco, ensuring improved access to effective tobacco use counseling and medication treatments.
From the Department of Family Medicine, University of North Carolina School of Medicine, Chapel Hill. carol_ripley-moffitt@med.unc.edu.
Carol
C
Ripley-Moffitt
From the Department of Family Medicine, University of North Carolina School of Medicine, Chapel Hill.
Dana
D
Neutze
From the Department of Family Medicine, University of North Carolina School of Medicine, Chapel Hill.
Mark
M
Gwynne
From the Department of Family Medicine, University of North Carolina School of Medicine, Chapel Hill.
Adam O
AO
Goldstein
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005194:Family Practice / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries; D012189:Retrospective Studies; D016540:Smoking Cessation / Q000379:methods*; D000074606:Smoking Prevention; D014029:Tobacco Use Disorder / Q000517:prevention & control*; D055815:Young Adult
Chronic Disease; Registries; Smoking Cessation; Substance Abuse; Tobacco Use