Department of Community and Behavioral Health, University of Colorado School of Public Health, Aurora, CO.
University of Colorado Cancer Center, Aurora, CO.
JCO Oncol Pract. 2023 Jan;19(1):e115-e124. doi: 10.1200/OP.22.00273. Epub 2022 Dec 14.
Because clinical specialists often lack time and training to address secondary health issues such as smoking cessation, the National Cancer Institute Cancer Center Cessation Initiative (C3I) has mobilized cancer centers to develop systems for treating patients' tobacco dependence.
One university-based cancer center was able to develop a program that formalized smoking treatment using a collaborative, multidisciplinary care team with overlapping expertise in cancer care, medication management, and tobacco cessation. Program planners delivered tobacco cessation services in the outpatient setting by automating identification of eligible patients using a tobacco registry in the electronic health records, directly involving oncology pharmacists in medication oversight, using dedicated tobacco treatment specialists to provide cessation services, and engaging oncologists through active communications protocols. Evaluators used Practical Robust Implementation and Sustainability Model as the guiding framework for a qualitative assessment of program development and implementation. Evaluators also measured provider satisfaction and utilization of services, program reach, and smoking cessation outcomes 6 months post enrollment.
During the evaluation period (July 1, 2018-September 30, 2019), the smoking cessation program engaged 96% of eligible patients (n = 214 of 223 eligible); 82% of those enrolled in the program (n = 183). At 6-month follow-up, 29.1% of enrolled patients self-reported 30-day point prevalence abstinence (n = 53) and 34.9% (n = 64) reported 7-day point prevalence abstinence (intent-to-treat rates).
Using a team-based approach that leverages individual expertise and interprofessional collaboration to provide patient-centered treatment, a smoking cessation program can identify and treat eligible patients in specialty clinics.
由于临床专家通常缺乏时间和培训来解决诸如戒烟等次要健康问题，因此美国国立癌症研究所癌症中心戒烟倡议（C3I）已动员癌症中心开发治疗患者烟草依赖的系统。
一个基于大学的癌症中心能够制定一项计划，该计划通过使用具有癌症护理，药物管理和戒烟方面重叠专业知识的协作式多学科护理团队，使吸烟治疗正式化。计划制定者通过在电子病历中的烟草登记处自动识别合格患者，直接让肿瘤药师参与药物监督，使用专门的烟草治疗专家提供戒烟服务，并通过积极的沟通协议使肿瘤医生参与，从而在门诊环境中提供戒烟服务。评估人员使用实用的稳健实施和可持续性模型作为计划开发和实施的定性评估的指导框架。评估人员还测量了提供者的满意度和服务利用率，计划的覆盖面以及注册后 6 个月的戒烟结果。
在评估期（2018 年 7 月 1 日至 2019 年 9 月 30 日），戒烟计划使 96％的合格患者（n = 214 名符合条件的患者中的 214 名）参与；该计划中，有 82％的患者（n = 183）参与。在 6 个月的随访中，有 29.1％的入组患者报告了 30 天点流行率戒烟（n = 53），34.9％（n = 64）报告了 7 天点流行率戒烟（意向治疗率）。
使用基于团队的方法，利用个人专业知识和跨专业合作，为患者提供以患者为中心的治疗，戒烟计划可以在专科诊所中识别和治疗合格的患者。
