System Based Tracking and Treatment for Emergency Patients Who Smoke: STTEPS

Study Summary

Emergency Departments (EDs) are a critical component of the U.S. healthcare system, treating over 119 million patients each year. While EDs have historically neglected tobacco control efforts, several recent studies have examined the feasibility and efficacy of implementing tobacco cessation in the ED. Work by our research team and others, has shown that tobacco treatment is both feasible and effective in the ED setting. Effective, evidence-based interventions for treating tobacco dependence have also been codified in the United States Public Health Service guidelines. Even brief interventions delivered by physicians and other healthcare providers can produce significant increases in cessation across diverse clinical settings (e.g., outpatient clinics, surgery units, EDs), and patient groups (cardiac, respiratory, general admissions). However, in clinical practice, delivery of tobacco interventions is inconsistent at best, particularly in non-primary care settings. This translational study uses an existing Emergency Department Information System (EDIS), to facilitate the identification of smokers and to enhance the provision of smoking cessation intervention materials and pharmacological adjuncts for patients receiving treatment in the ED. The EDIS tracks the geographic and chronologic progression of patients through the ED and contains triage and nursing notes, lab values, radiology reports and links to images, vital signs, embedded printable discharge instructions, and fax links to primary care provider (PCP) offices. Following recruitment of a baseline (care-as-usual) cohort (Step 1), the investigators will provide training to ED physicians and staff to improve the identification and treatment of smokers. Following Step 1, the investigators will make adaptations to the EDIS system that include smoking status tracking, tobacco treatment prompts and medication information panels for the emergency treating physician, and links to printable discharge instructions,

Primary Outcome

Smoking abstinence at 6 month follow up. Abstinence is determined by Cotinine validated 7-day point prevalence abstinence at each follow up (24 hour, 3 month, 6, month)

Conditions Studied

Interventions

• OTHER EDIS
• OTHER Care as usual

Study Locations (2)