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Tobacco Use Screening and Counseling During Hospital Outpatient Visits Among US Adults, 2005-2010.

Jamal A, Dube SR, King BA - Prev Chronic Dis (2015)

Bottom Line: Physicians and health care providers play an important role in educating their patients about the health risks of tobacco use and in providing effective cessation interventions.From 2005 through 2010, tobacco use screening (P for trend = .06) and cessation assistance (P for trend = .17) did not change significantly.Opportunities also exist to expand the coverage for tobacco cessation.

View Article: PubMed Central - PubMed

Affiliation: Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy, Mail Stop F79, Atlanta, GA 30341. Email: jze1@cdc.gov.

ABSTRACT

Introduction: Physicians and health care providers play an important role in educating their patients about the health risks of tobacco use and in providing effective cessation interventions. Little is known about these practices in hospital outpatient settings. The objective of the study was to assess the prevalence, correlates, and trends of tobacco use screening and cessation assistance offered to US adults during their hospital outpatient clinic visits.

Methods: Data for aggregated hospital outpatient visits among patients aged 18 years or older (N = 148,727) from the 2005-2010 National Hospital Ambulatory Medical Care Survey were analyzed. Tobacco use screening was defined as documentation of screening for either current tobacco use (cigarettes, cigars, snuff, or chewing tobacco) or no current use on the patient record form. Tobacco cessation assistance was defined as documentation of either tobacco counseling or cessation medications.

Results: Tobacco use screening was reported for 63.0% (estimated 271 million visits) of hospital outpatient visits, and cessation assistance was reported for 24.5% (estimated 17.1 million visits) of visits among current tobacco users. From 2005 through 2010, tobacco use screening (P for trend = .06) and cessation assistance (P for trend = .17) did not change significantly.

Conclusion: From 2005 through 2010, more than one-third of hospital outpatient visits had no screening for tobacco use, and among current tobacco users, only 1 in 4 received any cessation assistance. Health care providers should consistently identify and document their patients' tobacco use status and provide them with appropriate tobacco cessation assistance. Opportunities also exist to expand the coverage for tobacco cessation.

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Percentage of cessation assistance (counseling, or medications, or both) ordered or provided during hospital outpatient visits by adults aged ≥18 years, National Hospital Ambulatory Medical Care Survey, United States 2005–2010.YearCessation Assistance, %200525.6200625.6200725.2200824.3200924.4201021.6
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Figure 2: Percentage of cessation assistance (counseling, or medications, or both) ordered or provided during hospital outpatient visits by adults aged ≥18 years, National Hospital Ambulatory Medical Care Survey, United States 2005–2010.YearCessation Assistance, %200525.6200625.6200725.2200824.3200924.4201021.6

Mentions: Among patients who screened positive for current tobacco use, 24.5% (or an estimated 17.1 million visits) received any cessation assistance, including tobacco counseling, a prescription or order for a cessation medication at the visit, or both. Cessation assistance was higher for visits made by those with Medicaid/SCHIP (27.6%) than those with private insurance (21.8%) or Medicare (21.4%). Patients living in a high poverty zone were more likely to receive cessation assistance (zip code with 5.00%–9.99% poverty, 23.4% of visits; zip code with 10.00%–19.99% poverty, 23.8% of visits; and zip code with ≥20.00% poverty: 29.1% of visits) than those living in a low poverty zone (zip code with <5.00% poverty, 15.7% of visits). Receipt of cessation assistance was higher among those who visited their primary care physician (29.2% of visits) than those who visited a physician who was not their primary care physician (20.6% of visits). By major reason for the visit, cessation assistance was higher for preventive care (30.5% of visits) and chronic problems (26.8% of visits) than those for new problems (20.7% of visits), presurgery or postsurgery (17.5% of visits), and overall nonpreventive care (23.6% of visits). Higher prevalence of assistance was observed among patients who made a visit to general medicine clinics (26.7% of visits) than those made to surgical clinics (12.7% of visits). From 2005 through 2010, cessation assistance did not change over time after adjusting for sex, age, and race/ethnicity (P for trend = .17) (Figure 2).


Tobacco Use Screening and Counseling During Hospital Outpatient Visits Among US Adults, 2005-2010.

Jamal A, Dube SR, King BA - Prev Chronic Dis (2015)

Percentage of cessation assistance (counseling, or medications, or both) ordered or provided during hospital outpatient visits by adults aged ≥18 years, National Hospital Ambulatory Medical Care Survey, United States 2005–2010.YearCessation Assistance, %200525.6200625.6200725.2200824.3200924.4201021.6
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4556106&req=5

Figure 2: Percentage of cessation assistance (counseling, or medications, or both) ordered or provided during hospital outpatient visits by adults aged ≥18 years, National Hospital Ambulatory Medical Care Survey, United States 2005–2010.YearCessation Assistance, %200525.6200625.6200725.2200824.3200924.4201021.6
Mentions: Among patients who screened positive for current tobacco use, 24.5% (or an estimated 17.1 million visits) received any cessation assistance, including tobacco counseling, a prescription or order for a cessation medication at the visit, or both. Cessation assistance was higher for visits made by those with Medicaid/SCHIP (27.6%) than those with private insurance (21.8%) or Medicare (21.4%). Patients living in a high poverty zone were more likely to receive cessation assistance (zip code with 5.00%–9.99% poverty, 23.4% of visits; zip code with 10.00%–19.99% poverty, 23.8% of visits; and zip code with ≥20.00% poverty: 29.1% of visits) than those living in a low poverty zone (zip code with <5.00% poverty, 15.7% of visits). Receipt of cessation assistance was higher among those who visited their primary care physician (29.2% of visits) than those who visited a physician who was not their primary care physician (20.6% of visits). By major reason for the visit, cessation assistance was higher for preventive care (30.5% of visits) and chronic problems (26.8% of visits) than those for new problems (20.7% of visits), presurgery or postsurgery (17.5% of visits), and overall nonpreventive care (23.6% of visits). Higher prevalence of assistance was observed among patients who made a visit to general medicine clinics (26.7% of visits) than those made to surgical clinics (12.7% of visits). From 2005 through 2010, cessation assistance did not change over time after adjusting for sex, age, and race/ethnicity (P for trend = .17) (Figure 2).

Bottom Line: Physicians and health care providers play an important role in educating their patients about the health risks of tobacco use and in providing effective cessation interventions.From 2005 through 2010, tobacco use screening (P for trend = .06) and cessation assistance (P for trend = .17) did not change significantly.Opportunities also exist to expand the coverage for tobacco cessation.

View Article: PubMed Central - PubMed

Affiliation: Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy, Mail Stop F79, Atlanta, GA 30341. Email: jze1@cdc.gov.

ABSTRACT

Introduction: Physicians and health care providers play an important role in educating their patients about the health risks of tobacco use and in providing effective cessation interventions. Little is known about these practices in hospital outpatient settings. The objective of the study was to assess the prevalence, correlates, and trends of tobacco use screening and cessation assistance offered to US adults during their hospital outpatient clinic visits.

Methods: Data for aggregated hospital outpatient visits among patients aged 18 years or older (N = 148,727) from the 2005-2010 National Hospital Ambulatory Medical Care Survey were analyzed. Tobacco use screening was defined as documentation of screening for either current tobacco use (cigarettes, cigars, snuff, or chewing tobacco) or no current use on the patient record form. Tobacco cessation assistance was defined as documentation of either tobacco counseling or cessation medications.

Results: Tobacco use screening was reported for 63.0% (estimated 271 million visits) of hospital outpatient visits, and cessation assistance was reported for 24.5% (estimated 17.1 million visits) of visits among current tobacco users. From 2005 through 2010, tobacco use screening (P for trend = .06) and cessation assistance (P for trend = .17) did not change significantly.

Conclusion: From 2005 through 2010, more than one-third of hospital outpatient visits had no screening for tobacco use, and among current tobacco users, only 1 in 4 received any cessation assistance. Health care providers should consistently identify and document their patients' tobacco use status and provide them with appropriate tobacco cessation assistance. Opportunities also exist to expand the coverage for tobacco cessation.

Show MeSH