ArticleAmerican journal of preventive medicine2021
Closed-Loop Electronic Referral From Primary Care Clinics to a State Tobacco Cessation Quitline: Effects Using Real-World Implementation Training.
Article in American journal of preventive medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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The trial behind it
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Who cites it
20 citing papers in PubMed.
- Cost-Effectiveness of a Comprehensive Primary Care Smoking Treatment Program.American journal of preventive medicine · 2024Trial
- An EHR-automated and theory-based population health management intervention for smoking cessation in diverse low-income patients of safety-net health centers: a pilot randomized controlled trial.Translational behavioral medicine · 2022Trial
- A Randomized Trial of Telephone-Based Smoking Cessation Treatment in the Lung Cancer Screening Setting.Journal of the National Cancer Institute · 2022Trial
- Theory-based strategies to enhance interventions for smoking: Relevance to a digital intervention.Behaviour research and therapy · 2025Review
- Representativeness of Electronic Referral to Smoking Treatment Trials in Adult Primary Care.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2025Article
- Quitline Queensland: the journey to a globally unique smoking cessation service in Australia.Frontiers in public health · 2025Article
- Knowledge, attitudes, and referral practices for smokers to a state tobacco quitline in a federally qualified healthcare center: Healthcare provider perspectives.Tobacco prevention & cessation · 2024Article
- Texas tobacco quitline knowledge, attitudes, and practices within healthcare agencies serving individuals with behavioral health needs: A multimethod study.Preventive medicine reports · 2023Article
- Interdisciplinary Approach to Developing Nicotine Dependence Treatment Order Set: An Innovative Pilot Implementation.Mayo Clinic proceedings. Digital health · 2023Article
- Qualitative evaluation of the implementation and future sustainability of an e-referral system for smoking cessation at a US NCI-designated comprehensive cancer center: lessons learned.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2023Article
- Integrating Tobacco Treatment Into Oncology Care: Reach and Effectiveness of Evidence-Based Tobacco Treatment Across National Cancer Institute-Designated Cancer Centers.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2023Article
- Data envelopment analysis to evaluate the efficiency of tobacco treatment programs in the NCI Moonshot Cancer Center Cessation Initiative.Implementation science communications · 2023Article
- The Bucket Approach: Developing and Implementing an On-line Training Program in Tobacco Dependence Interventions Tailored for Behavioral Health Clinicians.Community mental health journal · 2023Article
- A comprehensive electronic health record-enabled smoking treatment program: Evaluating reach and effectiveness in primary care in a multiple baseline design.Preventive medicine · 2022Article
- Electronic health record closed-loop referral ("eReferral") to a state tobacco quitline: a retrospective case study of primary care implementation challenges and adaptations.Implementation science communications · 2022Article
- Can inpatient pharmacists move the needle on smoking cessation? Evaluating reach and representativeness of a pharmacist-led opt-out smoking cessation intervention protocol for hospital settings.American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists · 2022Article
- Point of care tobacco treatment sustains during COVID-19, a global pandemic.Cancer epidemiology · 2022Article
- Reach and effectiveness of the NCI Cancer Moonshot-funded Cancer Center Cessation Initiative.Translational behavioral medicine · 2022Article
- Evidence-based smoking cessation treatment: a comparison by healthcare system.BMC health services research · 2021Article
- Achieving Equity in the Reach of Smoking Cessation Services Within the NCI Cancer Moonshot-Funded Cancer Center Cessation Initiative.Health equity · 2021Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
introductionPatients who use tobacco are too rarely connected with tobacco use treatment during healthcare visits. Electronic health record enhancements may increase such referrals in primary care settings. This project used the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework to assess the implementation of a healthcare system change carried out in an externally valid manner (executed by the healthcare system).
methodsThe healthcare system used their standard, computer-based training approach to implement the electronic health record and clinic workflow changes for electronic referral in 30 primary care clinics that previously used faxed quitline referral. Electronic health record data captured rates of assessment of readiness to quit and quitline referral 4 months before implementation and 8 months (May-December 2017) after implementation. Data, analyzed from October 2018 to June 2019, also reflected intervention reach, adoption, and maintenance.
resultsFor reach and effectiveness, from before to after implementation for electronic referral, among adult patients who smoked, assessment of readiness to quit increased from 24.8% (2,126 of 8,569) to 93.2% (11,163 of 11,977), quitline referrals increased from 1.7% (143 of 8,569) to 11.3% (1,351 of 11,977), and 3.6% were connected with the quitline after implementation. For representativeness of reach, electronic referral rates were especially high for women, African Americans, and Medicaid patients. For adoption, 52.6% of staff who roomed at least 1 patient who smoked referred to the quitline. For maintenance, electronic referral rates fell by approximately 60% over 8 months but remained higher than pre-implementation rates.
conclusionsReal-world implementation of an electronic health record-based electronic referral system markedly increased readiness to quit assessment and quitline referral rates in primary care patients. Future research should focus on implementation methods that produce more consistent implementation and better maintenance of electronic referral.
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