Emergency department provider preferences related to clinical practice guidelines for tobacco cessation: a multicenter survey
Department of Emergency Medicine
Adult; *Attitude of Health Personnel; Counseling; Emergency Service, Hospital; Female; Guideline Adherence; Health Care Surveys; Humans; Male; Multicenter Studies as Topic; Patient Education as Topic; Practice Guidelines as Topic; Referral and Consultation; Smoking Cessation; United States
Emergency Medicine | Health Services Administration | Substance Abuse and Addiction
OBJECTIVES: The objective was to assess current emergency department (ED) provider practices and preferences for tobacco cessation interventions. The ED is an opportune place to initiate smoking cessation interventions. However, little is known about ED provider current practices and preferences for cessation counseling in the ED.
METHODS: This was a survey of ED providers conducted in 2008-2009 (including physicians, nurse practitioners, physician assistants, and nurses), working at least half-time at 10 U.S. academic EDs, regarding adherence to clinical practice guidelines ("5 As") and preferences for cessation interventions/styles. Data analysis occurred in 2012-2013.
RESULTS: The response rate was 64% (800 out of 1,246 completed surveys). Providers reported strongest adherence to asking about patient smoking status, followed by advising, with significant variance by clinical role. Assessing, assisting, and arranging support for patients was low overall. Most frequently used interventions were to provide patients with a list of telephone numbers for stop-smoking counseling (87%), pamphlets on smoking health risks and the benefits of stopping (85%), and referrals to the National Toll-Free Smoker's Quitline (84%). Most providers (80%) were supportive of personally conducting brief (less than 3 minutes) smoking cessation counseling sessions during the ED visit, emphasizing education and encouragement. The least appealing intervention was writing a prescription for nicotine replacement therapies or medications to stop smoking (35%).
CONCLUSIONS: Interventions most likely to be used were brief and delivered with a positive tone and included referral to external resources. The logical next step is to design and test interventions that ED providers find acceptable.
DOI of Published Version
Acad Emerg Med. 2014 Jul;21(7):785-93. doi: 10.1111/acem.12421. Epub 2014 Aug 11. Link to article on publisher's site
Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
Walters, Elizabeth L.; Reibling, Ellen T.; Wilber, Scott T.; Sullivan, Ashley F.; Gaeta, Theodore J.; Camargo, Carlos A. Jr.; and Boudreaux, Edwin D., "Emergency department provider preferences related to clinical practice guidelines for tobacco cessation: a multicenter survey" (2014). University of Massachusetts Medical School Faculty Publications. 677.