405A Harris Hall, Department of Community Health and Social Medicine, The Sophie Davis School of Biomedical Education, City College of New York, 160 Convent Avenue, New York, NY 10031, USA.
J Dent Educ. 2013 Apr;77(4):458-62.
This study tested the feasibility of using information technology to improve dentists' adherence to the Treating Tobacco Use and Dependence Clinical Practice Guidelines by offering a web-based computer-mediated clinical decision support system (CDSS) for tobacco use treatment in dental clinics. The authors developed a CDSS tool, deployed the software in one of New York University College of Dentistry's general practice clinics, interviewed associate student dentists, and reviewed a random selection of patients' charts to determine if, after implementation, there were changes in tobacco use screening and referral to treatment. Students reported that the CDSS was easy to use, increased their efficiency, and provided better quality of evidence than was available prior to the intervention. Chart reviews demonstrated that, after CDSS implementation, patients in the target clinic were significantly more likely to be screened for tobacco use (<0.001), and tobacco-using patients were more likely to be advised (<0.001), referred to the state's Quit Line (<0.001), and prescribed nicotine replacement therapy (0.035). This study concludes that it is feasible to implement a CDSS for tobacco use treatment in dental clinics. The CDSS is a promising method for improving adherence to tobacco use treatment guidelines and warrants further study.
本研究旨在测试利用信息技术提高牙医对《治疗烟草使用和依赖临床实践指南》的依从性的可行性,为此在牙科诊所提供了一个基于网络的计算机介导的临床决策支持系统(CDSS)来进行烟草使用治疗。作者开发了一个 CDSS 工具,将该软件部署在纽约大学牙科学院的一个普通诊所中,对实习牙医进行了访谈,并对随机选择的患者的图表进行了审查,以确定实施后是否在烟草使用筛查和转介治疗方面发生了变化。学生们报告说,CDSS 使用方便,提高了他们的工作效率,并提供了比干预前更好的证据质量。图表审查表明,在 CDSS 实施后,目标诊所的患者接受烟草使用筛查的可能性显著增加(<0.001),而且使用烟草的患者更有可能被建议(<0.001)、转介到州戒烟热线(<0.001)和开尼古丁替代疗法(0.035)。本研究得出结论,在牙科诊所实施 CDSS 进行烟草使用治疗是可行的。CDSS 是一种有前途的方法,可以提高对烟草使用治疗指南的依从性,值得进一步研究。