Evidence-based smoking cessation treatment: a comparison by healthcare system.

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  • Additional Information
    • Source:
      Publisher: BioMed Central Country of Publication: England NLM ID: 101088677 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-6963 (Electronic) Linking ISSN: 14726963 NLM ISO Abbreviation: BMC Health Serv Res Subsets: MEDLINE
    • Publication Information:
      Original Publication: London : BioMed Central, [2001-
    • Subject Terms:
      Evidence-Based Medicine* ; Guideline Adherence* ; Smoking Cessation*; Counseling ; Cross-Sectional Studies ; Delivery of Health Care ; Female ; Health Personnel ; Humans
    • Abstract:
      Background: A systems-level approach to smoking cessation treatment may optimize healthcare provider adherence to guidelines. Institutions such as the Veterans Health Administration (VHA) are unique in their systematic approach, but comparisons of provider behavior in different healthcare systems are limited.
      Methods: We surveyed general medicine providers and specialists in a large academic health center (AHC) and its affiliated VHA in the Mid-South in 2017 to determine the cross-sectional association of healthcare system in which the provider practiced (exposure: AHC versus VHA) with self-reported provision of evidence-based smoking cessation treatment (delivery of counseling plus smoking cessation medication or referral) at least once in the past 12 months (composite outcome). Multivariable logistic regression with adjustment for specialty was performed in 2017-2019.
      Results: Of 625 healthcare providers surveyed, 407 (65%) responded, and 366 (59%) were analyzed. Most respondents practiced at the AHC (273[75%] vs VHA 93[25%]) and were general internists (215[59%]); pulmonologists (39[11%]); hematologists/oncologists (69[19%]); and gynecologists (43[12%]). Most respondents (328[90%]) reported the primary outcome. The adjusted odds of evidence-based smoking cessation treatment were higher among VHA vs. AHC healthcare providers (aOR = 4.3; 95% CI 1.3-14.4; p = .02). Health systems differed by provision of individual treatment components, including smoking cessation medication use (98% VHA vs. 90% AHC, p = 0.02) and referral to smoking cessation services (91% VHA vs. 65% AHC p = 0.001).
      Conclusions: VHA healthcare providers were significantly more likely to provide evidence-based smoking cessation treatment compared to AHC healthcare providers. Healthcare systems' prioritization of and investment in smoking cessation treatment is critical to improving providers' adherence to guidelines.
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    • Grant Information:
      UL1 TR000445 United States TR NCATS NIH HHS; T32 HS026122 United States HS AHRQ HHS; K12 HL137943 United States HL NHLBI NIH HHS; P30 CA068485 United States CA NCI NIH HHS; CA68485 United States CA NCI NIH HHS
    • Publication Date:
      Date Created: 20210108 Date Completed: 20210427 Latest Revision: 20240331
    • Publication Date:
      20240331
    • Accession Number:
      PMC7792006
    • Accession Number:
      10.1186/s12913-020-06016-5
    • Accession Number:
      33413353