Improving family physicians' use of evidence-based smoking cessation strategies: a cluster randomization trial.

Full Abstract

BACKGROUND:
Family physicians (FPs) in Australia underutilize effective strategies to help patients stop smoking. We conducted a cluster randomization trial to evaluate a multifaceted, practice-based intervention involving audit, feedback, and academic detailing to improve FP smoking cessation advice.

METHODS:
Sixty FPs in 39 practices participated. FPs' provision of smoking cessation advice was measured by patient recall, medical record audit, and FP self-report. Logistic regression analysis using generalized estimating equations was performed to assess improvements in practice, after adjustment for clustering by practice.

RESULTS:
Improvements between baseline and posttest in patient recall of FP advice about nicotine replacement patches and gum were significantly greater in the intervention than in the control group (P = 0.0056 and P = 0.0002, respectively). While there were substantial increases in patient recall of assessment of smoking status and FP use of "quit dates," behavioral advice, and written materials in the intervention group, these changes were not significantly greater than those in the control group. Notation of patients' smoking status and smoking cessation advice in medical records remained suboptimal in both groups.

CONCLUSIONS:
This multifaceted intervention was successful only in promoting FPs' use of nicotine replacement therapy. While the use of other effective cessation strategies appeared to increase, a larger trial is needed for further evaluation.

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Author information

Author/s: Young, Jane M (JM); D'Este, Catherine (C); Ward, Jeanette E (JE);

Affiliation: Surgical Outcomes Research Centre, Central Sydney Area Health Service, E9W, Royal Prince Alfred Hospital, Missenden Road, Camperdown, New South Wales 2050, Australia. jyoung(-atsign-)email.cs.nsw.gov.au

Journal and publication information

Publication Type: Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't

Journal: Preventive medicine (Prev Med), published in United States. (Language: eng)

Reference: 2002-Dec; vol 35 (issue 6) : pp 572-83

Dates: Created 2002/12/03; Completed 2003/03/06; Revised 2006/11/15;

PMID: 12460525, status: MEDLINE (last retrieval date: 11/6/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Logistic Models
Medical Audit
Mental Recall
Middle Aged
New South Wales
Physician-Patient Relations
Physicians, Family - education; psychology; standards
Quality Assurance, Health Care
Smoking Cessation - methods

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