Greiver Michelle, Aliarzadeh Babak, Meaney Christopher, Moineddin Rahim, Southgate Chris A, Barber David T S, White David G, Martin Ken B, Ikhtiar Tabassum, Williamson Tyler
Department of Family and Community Medicine, University of Toronto; North York General Hospital, Toronto.
Department of Family and Community Medicine, University of Toronto; North York General Hospital, Toronto.
Am J Prev Med. 2015 Aug;49(2):264-8. doi: 10.1016/j.amepre.2015.01.005. Epub 2015 May 18.
All adolescent and adult patients should be asked if they smoke. Data entered in electronic medical records offer new opportunities to study tobacco-related clinical activities. The purpose of this study is to examine the recording of tobacco use in Canadian electronic medical records.
Data were collected on September 30, 2013, and analyzed in 2014. Data on 249,223 patients that were aged ≥16 years as of September 30, 2013 and had at least one primary care encounter in the previous 2 years were included. The proportion of patients with information on tobacco use entered in a summative health profile was calculated. Associations between data gaps and patient or physician factors were examined.
Information on tobacco use was available for 64.4% of patients. Physicians using an electronic medical record for ≥4 years were more likely to have data (AOR=4.57, 95% CI=1.84, 7.29, p<0.0001). Patients aged ≥30 years were more likely to have tobacco information present (AOR=2.92, 95% CI=2.82, 3.02, p<0.0001, for patients aged 30-59 compared to those aged <30 years), as were patients with any comorbidities (AOR=1.41, 95% CI=1.36, 1.45, p<0.0001, for patients with one or two comorbidities compared with none) or more visits.
A third of Canadians in this sample lacked data on tobacco in their electronic medical record. Younger, healthier people were less likely to have information about their smoking status. Efforts to improve the recording of tobacco-related information in electronic medical records, especially for younger patients, are needed.
所有青少年及成年患者均应被询问是否吸烟。电子病历中录入的数据为研究与烟草相关的临床活动提供了新机会。本研究旨在调查加拿大电子病历中烟草使用情况的记录。
于2013年9月30日收集数据，并于2014年进行分析。纳入截至2013年9月30日年龄≥16岁且在过去2年中至少有一次初级保健就诊经历的249,223例患者的数据。计算在汇总健康档案中录入了烟草使用信息的患者比例。研究数据缺口与患者或医生因素之间的关联。
64.4%的患者有烟草使用信息。使用电子病历≥4年的医生更有可能有相关数据（比值比[AOR]=4.57，95%置信区间[CI]=1.84, 7.29，p<0.0001）。≥30岁的患者更有可能有烟草信息（30至59岁患者与<30岁患者相比，AOR=2.92，95% CI=2.82, 3.02，p<0.0001），有任何合并症的患者（有一或两种合并症的患者与无合并症患者相比，AOR=1.41，95% CI=1.36, 1.45，p<0.0001）或就诊次数更多的患者也是如此。
该样本中三分之一的加拿大人在其电子病历中缺乏烟草相关数据。更年轻、更健康的人不太可能有关于其吸烟状况的信息。需要努力改善电子病历中与烟草相关信息的记录，尤其是针对年轻患者。
