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电子病历提醒与初级保健中的戒烟活动。

Electronic medical record reminders and smoking cessation activities in primary care.

机构信息

School of Nursing and Health Studies, Northern Illinois University, Wirtz Hall 257, Dekalb, IL 60115, United States.

Health Care Organization and Policy, University of Alabama Birmingham, 1665 University Blvd., Birmingham, AL 35294, United States.

出版信息

Addict Behav. 2018 Feb;77:203-209. doi: 10.1016/j.addbeh.2017.10.009. Epub 2017 Oct 16.

Abstract

PURPOSE

The purpose of this paper is to assess electronic medical record (EMR) automatic reminder use in relation to smoking cessation activities among primary-care providers.

BACKGROUND

Primary-care physicians are in the frontline of efforts to promote smoking cessation. Moreover, doctors' prescribing privileges give them additional tools to help patients successfully quit smoking. New EMR functions can provide automated reminders for physicians to counsel smokers and provide prescriptions to support quit attempts.

SAMPLE AND METHODS

Logit regression is used to analyze the 2012 National Ambulatory Medical Care Survey (NAMCS). Variables related to the EMR's clinical reminder capability, patient's smoking status, the provision of cessation counseling and the prescribing of drugs that support quitting are analyzed.

RESULTS

For primary care visit documents, smoking status was recorded 77.7% of the time. Smoking cessation counseling was ordered/provided 16.4% of the time in physicians' offices using electronic reminders routinely compared to 9.1% in those lacking the functionality. Smoking cessation medication was ordered/prescribed for 3.7% of current smokers when reminders were routinely used versus 2.1% when no reminder was used. All the differences were statistically significant.

CONCLUSIONS

The presence of an EMR equipped with automated clinical reminders is a valuable resource in efforts to promote smoking cessation. Insurers, regulators, and organizations promulgating clinical guidelines should include the use of EMR technology as part of their programs.

摘要

目的

本文旨在评估电子病历(EMR)自动提醒在初级保健提供者的戒烟活动中的使用情况。

背景

初级保健医生是促进戒烟努力的第一线。此外,医生的处方权使他们有更多的工具来帮助患者成功戒烟。新的 EMR 功能可以为医生提供自动提醒,以咨询吸烟者并提供支持戒烟尝试的处方。

样本和方法

使用逻辑回归分析 2012 年全国门诊医疗调查(NAMCS)。分析与 EMR 临床提醒功能、患者吸烟状况、提供戒烟咨询和开具支持戒烟药物相关的变量。

结果

对于初级保健就诊记录,吸烟状况被记录的时间为 77.7%。在常规使用电子提醒的医生办公室中,戒烟咨询的开具/提供率为 16.4%,而缺乏该功能的医生办公室中为 9.1%。当常规使用戒烟药物提醒时,为 3.7%的当前吸烟者开具/开出处方,而当不使用提醒时,为 2.1%。所有差异均具有统计学意义。

结论

配备自动临床提醒功能的 EMR 的存在是促进戒烟的宝贵资源。保险公司、监管机构和发布临床指南的组织应将 EMR 技术的使用纳入其计划的一部分。

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