Physician‐directed smoking cessation using patient “opt‐out” approach in the emergency department: A pilot program
Objective Using a physician‐directed, patient “opt‐out” approach to prescriptive smoking cessation in the emergency department (ED) setting, we set out to describe patient actions as they related to smoking cessation behaviors. Methods A convenience sample of smokers at 2 Pennsylvania hospital EDs w...
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| Published in: | Journal of the American College of Emergency Physicians Open Vol. 1; no. 5; pp. 782 - 789 |
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| Main Authors: | , , , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
United States
John Wiley and Sons Inc
01-10-2020
Wiley |
| Subjects: | |
| Online Access: | Get full text |
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| Summary: | Objective
Using a physician‐directed, patient “opt‐out” approach to prescriptive smoking cessation in the emergency department (ED) setting, we set out to describe patient actions as they related to smoking cessation behaviors.
Methods
A convenience sample of smokers at 2 Pennsylvania hospital EDs who met inclusion/exclusion criteria were approached to participate in a brief intervention known as screening, treatment initiation, and referral (STIR) counseling that included phone follow‐up. Demographic information, current smoking status, and specific physician prescription and follow‐up recommendations were collected. Approximately 3 months later, patients were contacted to determine current smoking status and actions taken since their ED visit.
Results
One hundred six patients were approached and 7 (6.6%) opted out of the intervention. Patients who did not opt out were evaluated for appropriate use of smoking cessation‐related medications; 35 (35.4%) opted out of the prescription(s) and 6 (6.1%) were not indicated. Twenty‐one (21.2%) patients opted out of ambulatory referral follow‐ups with primary care and/or tobacco treatment program; one (1.0%) was not indicated for referral. Nineteen (32.8%) patients who received prescription(s) for smoking cessation‐related medications initially also followed the prescription(s). Seventeen (22.1%) patients participated in referral follow‐up.
Conclusion
In this small ED pilot, using the STIR concepts in an opt‐out method, few smokers opted out of the smoking cessation intervention. About one‐third of the patients declined prescriptions for smoking cessation‐related medications and less than one‐quarter declined ambulatory referrals for follow‐up. These findings support a willingness of patients to participate in STIR and the benefits of intervention in this setting. |
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| Bibliography: | This work was presented virtually, in part, as an abstract at the American College of Osteopathic Emergency Physicians (ACOEP) Spring Seminar, April 14, 2020; it was also accepted for presentation, in part, as an abstract at the Pennsylvania College of Emergency Physicians (PACEP) Scientific Assembly, Spivey Research Competition, on April 2, 2020 in Pittsburgh, PA. Because of restrictions from COVID‐19, the abstract was posted online but not presented. Supervising Editor: Chadd K. Kraus, DO, DrPH. Funding and support: MG was project leader for this QI project. The network received funding from Pfizer, Inc. to support this project. EC is employed by Pfizer, Inc. ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
| ISSN: | 2688-1152 2688-1152 |
| DOI: | 10.1002/emp2.12176 |