| Description |
For several decades, the United States Department of Health and Human Services (DHHS) has played an important role helping to guide preventive healthcare in our country. In order to better identify problem areas and assist healthcare providers in preventive care, the Agency for Healthcare Research and Quality (AHRQ) was created. The AHRQ provides up-to- date information on the latest evidence-based research in the form of guidelines that are disseminated for healthcare providers to follow in order to better the health care services of US citizens (Agency for Healthcare Research and Quality (AHRQ), August 2012). One such guideline that has been available since 2002 and updated in 2008 is "Treating Tobacco Use and Dependence" (Okuyemi, Ahluwalia, & Wadland, 2001). This guideline provides tools that can be used by primary care providers to identify smokers and counsel them about smoking cessation (Guideline Panel, 2008). There are currently about 45.3 million smokers in the US (Centers for Disease Control and Prevention [CDC], 2012). One in five deaths is associated with smoking (Benowitz, 2010; Smoking Statistics, February 2009). It has been reported by Strayer, Rollins, and Martindale (2006) that 23% to 46% of smokers visiting a primary care clinic are not identified as smokers or if they are, they do not receive counseling for smoking cessation. Therefore, the aim of this project is to obtain the tools and resources that are recommended by the AHRQ for smoking cessation counseling and implement a smoking cessation program in a small rural primary care clinic. Despite the significant decrease in smoking rates from the 1950's to 1990's, there is still room for improvement, especially among the younger generations (Black, 2010). The number of smokers who visit primary care providers each year offers an opportunity otherwise not available for smoking cessation counseling. The objectives for this project are focused on diminishing the barriers faced by health care providers and providing patients who smoke with information and resources to assist with smoking cessation. The literature reviewed for this project repeatedly identifies the failure of primary care providers to provide smoking cessation counseling mainly due to a lack of knowledge (Strayer et al., 2006). Research shows a gap in the curriculum of medical education regarding smoking cessation interventions, and Strayer et al. have found a lack of knowledge regarding AHRQs guideline and the tools available within the guideline for smoking cessation intervention. SMOKING CESSATION PROGRAM FOR A RURAL PRIMARY CARE 2 Executive Summary For several decades, the United States Department of Health and Human Services (DHHS) has played an important role helping to guide preventive healthcare in our country. In order to better identify problem areas and assist healthcare providers in preventive care, the Agency for Healthcare Research and Quality (AHRQ) was created. The AHRQ provides up-to- date information on the latest evidence-based research in the form of guidelines that are disseminated for healthcare providers to follow in order to better the health care services of US citizens (Agency for Healthcare Research and Quality (AHRQ), August 2012). One such guideline that has been available since 2002 and updated in 2008 is "Treating Tobacco Use and Dependence" (Okuyemi, Ahluwalia, & Wadland, 2001). This guideline provides tools that can be used by primary care providers to identify smokers and counsel them about smoking cessation (Guideline Panel, 2008). There are currently about 45.3 million smokers in the US (Centers for Disease Control and Prevention [CDC], 2012). One in five deaths is associated with smoking (Benowitz, 2010; Smoking Statistics, February 2009). It has been reported by Strayer, Rollins, and Martindale (2006) that 23% to 46% of smokers visiting a primary care clinic are not identified as smokers or if they are, they do not receive counseling for smoking cessation. Therefore, the aim of this project is to obtain the tools and resources that are recommended by the AHRQ for smoking cessation counseling and implement a smoking cessation program in a small rural primary care clinic. Despite the significant decrease in smoking rates from the 1950's to 1990's, there is still room for improvement, especially among the younger generations (Black, 2010). The number of smokers who visit primary care providers each year offers an opportunity otherwise not available for smoking cessation counseling. The objectives for this project are focused on diminishing the barriers faced by health care providers and providing patients who smoke with information and resources to assist with smoking cessation. The literature reviewed for this project repeatedly identifies the failure of primary care providers to provide smoking cessation counseling mainly due to a lack of knowledge (Strayer et al., 2006). Research shows a gap in the curriculum of medical education regarding smoking cessation interventions, and Strayer et al. have found a lack of knowledge regarding AHRQs guideline and the tools available within the guideline for smoking cessation intervention. Implementation of the project began with a presentation and dissemination of "Treating Tobacco Use and Dependence: Quick Reference Guide for Clinicians-2008 Update". Medical assistants were provided with a tool to identify patients who currently smoke and this information was placed within the chief complaint of the electronic medical record. Patient education resources were obtained from the State of Utah, CDC, and the National Cancer Institute for dissemination to patients. For evaluation of the project, a total number of smokers per provider per day were collected. The number of patients per provider diagnosed with tobacco dependence and those who received counseling was collected and a percentage per provider was calculated to evaluate successfulness of the project. Upon completion of the project, similar findings were identified in comparison with the literature. Identification of patients who smoke has a very successful rate of >80%, but the follow through with the remaining of the Five A's, advise, assess, assist and arrange, fall off with each successive step. Other barriers identified in the literature such as time constraints, large patient load, perceived patient attitudes and provider attitudes were not overcome. |
