Trial reportJournal of clinical oncology : official journal of the American Society of Clinical Oncology2023
Cluster Randomized Pragmatic Clinical Trial Testing Behavioral Economic Implementation Strategies to Improve Tobacco Treatment for Patients With Cancer Who Smoke.
Trial report in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed.
- Pilot Trial of a Behavioral Economics-Informed Clinical Decision Support Alert to Improve Inpatient Tobacco Use Treatment Rates.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2025Trial
- Article
- Timely nudges promote patient portal enrollment and sustained engagement: a randomized controlled trial.JAMIA open · 2026Article
- Real-time automated billing for tobacco treatment: performance evaluation of the CigStopper machine learning framework.JAMIA open · 2026Article
- Application of Nudges to Design Clinical Decision Support Tools: Systematic Approach Guided by Implementation Science.Journal of medical Internet research · 2025Article
- A formative study to develop nudges informed by behavioral economics to increase engagement with tobacco treatment among people who smoke receiving care for HIV.Drug and alcohol dependence reports · 2025Article
- Integration of Germline Genetic Testing Into Routine Clinical Practice for Patients With Pancreatic Adenocarcinoma.JCO oncology practice · 2025Article
- Re-Envisioning Electronic Health Records to Optimize Patient-Centered Cancer Care, Quality, Surveillance, and Research.JCO oncology practice · 2025Article
- Clinicians' Use of Choice Framing in ICU Family Meetings.Critical care medicine · 2024Article
- Protocol for a type 3 hybrid implementation cluster randomized clinical trial to evaluate the effect of patient and clinician nudges to advance the use of genomic medicine across a diverse health system.Implementation science : IS · 2024Article
- Family cascade screening for equitable identification of familial hypercholesterolemia: study protocol for a hybrid effectiveness-implementation type III randomized controlled trial.Implementation science : IS · 2024Article
- Using the Translational Science Benefits Model to assess the impact of the Penn Implementation Science Center in Cancer Control.Journal of clinical and translational science · 2024Article
- Protocol for a pragmatic stepped wedge cluster randomized clinical trial testing behavioral economic implementation strategies to increase supplemental breast MRI screening among patients with extremely dense breasts.Implementation science : IS · 2023Article
- Protocol to evaluate sequential electronic health record-based strategies to increase genetic testing for breast and ovarian cancer risk across diverse patient populations in gynecology practices.Implementation science : IS · 2023Article
Corrections and comments
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Authors and funding
30 authors.
Funding
Abstract
purposeFew cancer centers systematically engage patients with evidence-based tobacco treatment despite its positive effect on quality of life and survival. Implementation strategies directed at patients, clinicians, or both may increase tobacco use treatment (TUT) within oncology.
methodsWe conducted a four-arm cluster-randomized pragmatic trial across 11 clinical sites comparing the effect of strategies informed by behavioral economics on TUT engagement during oncology encounters with cancer patients. We delivered electronic health record (EHR)-based nudges promoting TUT across four nudge conditions: patient only, clinician only, patient and clinician, or usual care. Nudges were designed to counteract cognitive biases that reduce TUT engagement. The primary outcome was TUT penetration, defined as the proportion of patients with documented TUT referral or a medication prescription in the EHR. Generalized estimating equations were used to estimate the parameters of a linear model.
resultsFrom June 2021 to July 2022, we randomly assigned 246 clinicians in 95 clusters, and collected TUT penetration data from their encounters with 2,146 eligible patients who smoke receiving oncologic care. Intent-to-treat (ITT) analysis showed that the clinician nudge led to a significant increase in TUT penetration versus usual care (35.6%
conclusionEHR nudges, informed by behavioral economics and aimed at oncology clinicians, appear to substantially increase TUT penetration. Adding patient nudges to the implementation strategy did not affect TUT penetration rates.
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