Silfen Sheryl L, Cha Jisung, Wang Jason J, Land Thomas G, Shih Sarah C
Sheryl L. Silfen, Jisung Cha, Jason J. Wang, Sarah C. Shih are affiliated with New York City Department of Health and Mental Hygiene, Queens, NY. Thomas G. Land is affiliated with the Massachusetts Department of Health, Boston.
Am J Public Health. 2015 Oct;105(10):2143-9. doi: 10.2105/AJPH.2014.302444. Epub 2015 Apr 16.
We used electronic health record (EHR) data to determine rates and patient characteristics in offering cessation interventions (counseling, medications, or referral) and initiating quit attempts.
Ten community health centers in New York City contributed 30 months of de-identified patient data from their EHRs.
Of 302 940 patients, 40% had smoking status recorded and only 34% of documented current smokers received an intervention. Women and younger patients were less likely to have their smoking status documented or to receive an intervention. Patients with comorbidities that are exacerbated by smoking were more likely to have status documented (82.2%) and to receive an intervention (52.1%), especially medication (10.8%). Medication, either alone (odds ratio [OR] = 1.9; 95% confidence interval [CI] = 1.5, 2.3) or combined with counseling (OR = 1.8; 95% CI = 1.5, 2.3), was associated with higher quit attempts compared with no intervention.
Data from EHRs demonstrated underdocumentation of smoking status and missed opportunities for cessation interventions. Use of data from EHRs can facilitate quality improvement efforts to increase screening and intervention delivery, with the potential to improve smoking cessation rates.
我们使用电子健康记录（EHR）数据来确定提供戒烟干预措施（咨询、药物治疗或转诊）及启动戒烟尝试的比例和患者特征。
纽约市的10家社区健康中心提供了其电子健康记录中30个月的匿名患者数据。
在302940名患者中，40%的患者记录了吸烟状况，而在记录在案的当前吸烟者中，只有34%接受了干预。女性和年轻患者记录吸烟状况或接受干预的可能性较小。吸烟会加重病情的合并症患者记录吸烟状况的可能性更大（82.2%），接受干预的可能性也更大（52.1%），尤其是药物治疗（10.8%）。与未进行干预相比，单独使用药物（比值比[OR]=1.9；95%置信区间[CI]=1.5，2.3）或药物与咨询相结合（OR=1.8；95%CI=1.5，2.3）与更高的戒烟尝试率相关。
电子健康记录数据显示吸烟状况记录不足以及戒烟干预存在错失机会的情况。利用电子健康记录数据有助于推动提高筛查和干预实施质量的工作，有可能提高戒烟率。
