Ask, Advise & Refer: Brief intervention to increase screening rates and cessation referrals

Transcription

1 Ask, Advise & Refer: Brief intervention to increase screening rates and cessation referrals NJ CANCER PREVENTION SUMMIT September 18, 2014 Merle J. Weitz, MSW

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3 Helping Patients Quit is a Clinician's Responsibility TOBACCO USERS DON T PLAN TO FAIL. MOST FAIL TO PLAN. Clinicians have a professional obligation to address tobacco use and can have an important role in helping patients plan for their quit attempts. THE DECISION TO QUIT LIES IN THE HANDS OF EACH PATIENT

4 Effects of Clinician Interventions Estimated abstinence at 5+ months n = 29 studies Compared to patients who receive no assistance from a clinician, patients who receive assistance are times as likely to quit successfully for 5 or more months No clinician Self-help material Nonphysician clinician Type of Clinician Physician clinician Fiore et al. (2008). Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. Rockville, MD: USDHHS, PHS, May 2008.

5 Clinicians are crucial to successful cessation Tobacco-cessation counseling by clinicians is effective in improving tobacco quit rates among adults and has been recommended for adolescents. 3% quit/year if you do nothing 6% quit for 6 months with 3 minute counseling or practice system

6 New Benefits to Clinicians Brief intervention model system wide with expanded interventions/messages to smoking patients will serve EMRs Meaningful use Billing codes being utilized and reimbursed for qualifying interventions

7 The First Step We MUST agree that cigarette use is an addiction. We MUST offer augmented rather than simple advise to quit. To be successful in treating tobacco dependence; we MUST offer evidencebased best practice for tobacco cessation.

8 The Second Step Become familiar about the hazards of smoking, second and third hand smoke. Commit to helping patients quit in order to prevent tobacco related illnesses and diseases.

9 Ask Advise with a Teachable Moment Clear, strong, personalized advice to quit Clear: My best advice for you is for you to quit smoking. Strong: As your clinician, I need you to know that quitting smoking is the most important thing you can do to protect your body, your future and your family s future. Personalized: Impact of smoking on the your body, your family, and your overall long term health and well being

10 Refer Brief counseling with self-help materials offered by a trained clinician can improve cessation rates by 30% to 70%. Refer patient/client to NJ Quitline Fax to Quit form Electronic referral Wallet card Website support tobaccofreenj.com njquitline.org

11 Studies show that only three to five percent of smokers are able to quit without any quitting assistance. The U.S. Public Health Service s recently updated clinical practice guideline found that Quitline counseling can more than double a smoker s chances of quitting and Quitline counseling combined with medication (such as nicotine replacement therapy) can more than triple the chances of quitting. Serve as a gateway to other cessation resources (e.g. medications), and in some cases link tobacco users to broader health-related information and resources (e.g., care for diabetes or hypertension)

12 Clinicians Underutilize NJ Quitline The provider education campaign funded for southern NJ began in the month of July 2010, when there were 26 registered QL callers referred from from health care providers statewide. The provider education campaign hosted approximately 25 Ask Advise Refer formal trainings/year, serving providers In the month of July 2014, there were 70 registered QL callers referred from health care providers

13 2013 System wide brief intervention Identified champions in hospitals to participate in brief intervention training Participants varied depending on health care system (may be patient navigators, social workers, case managers, educators, respiratory therapists or others In house brief intervention cessation counseling provided to inpatient smokers, admitted for tobacco related illness, including bedside referral to NJ Quitline

14 2013 System wide brief intervention Expanded brief intervention training to outpatient family practice office and oncology, cancer treatment centers Fax to Quit forms used to refer smokers to the NJ Quitline provided follow up outcome data for the hospitals Significant increase in referrals

15 Case study Local hospital using diabetes educators Average 32 referrals/month from that system County statistics for tobacco users that called and registered with the NJQL increased from 5.2 per month to 27 per month Utilized local Chronic Disease Coalition to promote model and recruit other hospital systems

16 Cessation education in the workplace Partnership with the City of Vineland Health Department Examined tobacco control, policies and practice,: provided assistance to wellness programs Cessation education, preparation, resources and referral to NJ Quitline Calls to NJ Quitline from Cumberland County have tripled from 2011 to 2014

17 Registered callers to NJ Quitline in Cumberland County June 2010-May 2011 june 2013-May Cumberland County Tobacco Users Registered with NJQL NJ QL Tobacco Users served by county : Roswell Park cancer Institute

18 New toolkit being developed to promote NJ Quitline Professionals Consumers Media

19 AVAILABLE TO: OFFICE BASED PRACTICE (family practice, cardiology, pulmonology, oncology ) HEALTH CARE SYSTEMS-hospitals, FQHCs PREVENTATIVE SCREENING PROGRAMS (cancer, lung, diabetes) WORKSITE WELLNESS PROGRAMS LOCAL HEALTH DEPARTMENTS PROFESSIONAL ORGANIZATIONS, COALITIONS AND MEDICAL TRAINING PROGRMS

20 For more information: Marketing/program development Merle J. Weitz Professional training Cathy Butler