Does Checking Smoking Status as a Vital Sign Increase Physician Counseling? A Practice-Level Randomized Controlled Trial
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 2,000
- 试验地点
- 2
- 主要终点
- Checking smoking status as a vital sign increases the practice-level rate of cessation counseling (any counseling beyond simply inquiring about smoking status) at visits by current adult smokers.
研究概览
简要总结
The purpose of this study is to determine if checking smoking status as a routine vital sign increases the delivery rate of cessation counseling to adult smokers in primary care practices.
详细描述
Two national clinical practice guidelines (CPGs) have advised primary care physicians to implement an office-wide system for screening and recording tobacco-use status for every patient at every office visit. These guidelines specifically recommended checking smoking status as a vital sign. This tracking system is elegantly simple: As a prompt for the physician, the nursing staff records the patient's response to a brief inquiry of their smoking status (current, former, never) with the other vital sign data.
Scientific evidence that this measure increases physician counseling or smoking cessation is limited. The proposed study evaluates the effectiveness of the vital sign intervention through a practice-level randomized controlled trial.
18 practices will be recruited for the 9 month study. Eligible practices will include primary care practices (family practice or internal medicine) with an average of two or more full-time equivalent providers (including physician assistants and nurse practitioners), not already using (or planning to institute during the study period) a practice-wide tobacco identification and reminder system, and willing to participate in the study.
Data collection will occur in two phases; baseline and post intervention. The purpose of baseline data collection is to provide a baseline counseling rate for each office prior to randomization.
Over the course of both data collection periods, research assistants (RAs) will visit individual practices on a rotating basis (about 16 visits per site on average). On average, practices will be visited once a week during the baseline month and twice a month during the intervention phase. The frequency of visits will be adjusted in an ongoing fashion by the PI, as practices with a smaller number of providers, a lower prevalence of smokers, or a lower survey participation rate will necessitate proportionally more visits to keep data collection balanced at each site.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Single Group
- 主要目的
- Other
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Current use of tobacco
- •Age 18 or older
- •Visit with a clinician that day
- •Patient at one of the 16 practices in the study
排除标准
- •Unable to participate in a self-administered exit survey
结局指标
主要结局
Checking smoking status as a vital sign increases the practice-level rate of cessation counseling (any counseling beyond simply inquiring about smoking status) at visits by current adult smokers.
次要结局
- Checking smoking status as a vital sign increases the practice-level rate of addressing two counseling subcomponents: simple quit advice and more intensive discussion.