Kruse Gina R, Kelley Jennifer H K, Chase Karen, Rigotti Nancy A
Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital.
Tobacco Research and Treatment Center, Massachusetts General Hospital.
JMIR Form Res. 2018 Jan-Jun;2(1). doi: 10.2196/formative.9608. Epub 2017 Dec 8.
Few smokers receive evidence-based cessation services during primary care visits. We aimed to assess the feasibility of a proactive text messaging program for primary care patients who smoke.
We used electronic health records (EHRs) to identify smokers from two Massachusetts community health centers who had a mobile phone number listed. In March 2014-June 2015 patients were screened by their primary care physician then sent a proactive text message inviting them to enroll by texting back. Patients who opted-in were asked about their readiness to quit. The text message program included messages from the QuitNowTXT library and novel content for smokers who were not ready to quit.
Among 949 eligible smokers, 88 (9%) enrolled after receiving a single proactive text message. Compared with those who did not enroll, enrollees were more often female (61% vs. 48%, p=0.02) but otherwise did not differ in age, race, insurance status, or comorbidities. Twenty-eight percent of enrollees were not ready to quit in the next 30 days. The median time in the program was 9 days (interquartile range 2-32). Twenty-five percent of current smokers sent one or more keyword requests to the server. These did not differ by readiness to quit.
A proactively delivered text messaging program targeting primary care patients who smoke was feasible and engaged both smokers ready to quit and those not ready to quit. This method shows promise as part of a population health model for addressing tobacco use outside of the primary care office.
很少有吸烟者在初级保健就诊期间接受循证戒烟服务。我们旨在评估针对吸烟的初级保健患者开展主动短信项目的可行性。
我们利用电子健康记录（EHRs）从马萨诸塞州的两个社区健康中心识别出登记有手机号码的吸烟者。在2014年3月至2015年6月期间，由初级保健医生对患者进行筛查，然后发送一条主动短信，邀请他们通过回复短信进行注册。选择加入的患者被询问其戒烟意愿。短信项目包括来自QuitNowTXT库的短信以及针对尚未准备好戒烟的吸烟者的新内容。
在949名符合条件的吸烟者中，88名（9%）在收到一条主动短信后注册。与未注册者相比，注册者女性比例更高（61%对48%，p=0.02），但在年龄、种族、保险状况或合并症方面没有差异。28%的注册者在接下来的30天内尚未准备好戒烟。该项目中的中位时间为9天（四分位间距为2 - 32天）。25%的当前吸烟者向服务器发送了一个或多个关键词请求。这些在戒烟意愿方面没有差异。
针对吸烟的初级保健患者开展主动发送短信的项目是可行的，并且能让准备好戒烟和尚未准备好戒烟的吸烟者都参与进来。这种方法有望成为在初级保健办公室之外解决烟草使用问题的人群健康模式的一部分。
