Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.
Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL 60611, USA.
Int J Environ Res Public Health. 2020 Jul 13;17(14):5034. doi: 10.3390/ijerph17145034.
Tobacco use negatively impacts cancer treatment outcomes, yet too few providers actively support their patients in quitting. Barriers to consistently addressing tobacco use and referring to treatment include time constraints and lack of knowledge surrounding treatment options. Patient Reported Outcomes (PRO) measurement is best practice in cancer care and has potential to help address these barriers to tobacco cessation treatment. This descriptive program evaluation study reports preliminary results following implementation of a novel automated PRO tobacco use screener and referral system via the electronic health record (EHR) patient portal (MyChart) that was developed and implemented as a part of a population-based tobacco treatment program at the Robert H. Lurie Comprehensive Cancer Center of Northwestern University. Between 25 June 2019 and 6 April 2020, 4589 unique patients completed the screener and 164 (3.6%) unique patients screened positive for recent (past month) cigarette smoking. All patients who screened positive were automatically referred to a smoking cessation treatment program integrated within the Lurie Cancer Center, and 71 (49.7%) patients engaged in treatment, as defined by completing at least one behavioral counseling session. Preliminary results indicate that the PRO/MyChart system may improve smoker identification and increase offering of treatment and, despite the "cold call" following a positive screen, may result in a treatment engagement rate that is higher than rates of treatment engagement previously documented in oncology settings. Longer term evaluation with formal statistical testing is needed before drawing conclusions regarding effectiveness, but PRO measurement via the EHR patient portal may serve a potentially important role in a multi-component approach to reaching and engaging cancer patients in comprehensive tobacco cessation treatment.
吸烟会对癌症治疗效果产生负面影响，但仍有极少数医生积极支持患者戒烟。在治疗过程中，始终如一地解决吸烟问题和转介治疗存在时间限制和对治疗选择缺乏了解等障碍。患者报告的结果（PRO）测量是癌症护理的最佳实践，并有潜力帮助解决这些戒烟治疗的障碍。这项描述性计划评估研究报告了在实施一种新的基于电子病历（EHR）患者门户（MyChart）的自动 PRO 烟草使用筛查和转介系统后的初步结果，该系统是作为西北大学罗伯特·H·卢里综合癌症中心基于人群的烟草治疗计划的一部分而开发和实施的。在 2019 年 6 月 25 日至 2020 年 4 月 6 日期间，有 4589 名独特患者完成了筛查，164 名（3.6%）独特患者最近（过去一个月）吸烟呈阳性。所有筛查呈阳性的患者都被自动转介到卢里癌症中心内的戒烟治疗计划，71 名（49.7%）患者参与了治疗，定义为至少完成一次行为咨询课程。初步结果表明，PRO/MyChart 系统可能会提高吸烟者的识别率，并增加治疗的提供，尽管在阳性筛查后进行了“冷电话”，但仍可能导致治疗参与率高于之前在肿瘤学环境中记录的治疗参与率。在得出有效性的结论之前，需要进行更长期的评估和正式的统计测试，但通过 EHR 患者门户进行 PRO 测量可能在多组件方法中发挥重要作用，以达到并使癌症患者全面参与综合戒烟治疗。
