Teresa Brown, BS, TTS Tobacco Prevention and Cessation Program

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1 Teresa Brown, BS, TTS Tobacco Prevention and Cessation Program

2 Hot Topic Breakout Session 12:45-1:45 / 1:45-2:45

3 Participants will: q Understand QUIT-NOW quitline tobacco treatment services q Understand QuitWorks-NH clinical referral resource to tobacco treatment services q Moving patients towards readiness to quit

4 What % of your patient population smokes? What % of your patient population chews? What % of your patient population has been referred for tobacco treatment? What was the outcome of that treatment? What is the quit rate among patient population?

5 6,000 research articles Dose-response Multiple medications Counseling Quitlines are effective American Academy of Family Physicians

6 Today s tobacco products contain higher amounts of nicotine More addictive Decreased effectiveness of current medication Co-morbid conditions are common Mental Illness/Substance Use Heart Disease High BP Diabetes

7 Advice Research Arms Estimated odds ratio (99% C.I.) Estimated Abstinence Rate (99% C.I.) No advice to quit Physician advice to quit ( ) 10.2 ( ) -Practitioners advice makes a difference -Requires repeated interventions -Motivational Interview skills are critical -Remains on the Problem List

8 Common practice to Ask- EHR How to Assist How to Refer ICD 10 codes for tobacco use/dependence Electronic referral protocol to any medical specialty group

9 Stage of readiness is critical Meet the patient where they are Message care, compassion and support Ask THEM what they want

10 Do you use any type of tobacco product, including e-cigarette? NO YES Is your first dose within 30 minute of waking? Once this has been documented In EHR just checking in that you continue to be tobacco-free. NO YES Have you ever tried to quit? NO YES NO Would you be ok with talking about quitting with Dr. X? I completely understand you are not ready (Patient Summary statement) Refer to QUITNOW/QuitNowNH.org YES Ok, I will make a note for Dr. X** Clinical Referral to QuitWorks-NH

11 Medication options-otc/rx Combined is best practice (nicotine tastes awful!) Chantix Myths Patch Myths E-cigarette Science

The importance of support Policies at work and clinic campus

12 Behavior Coaching options Smoking strongly linked to anxiety/depression In-house Behavior Specialist available? The importance of support Policies at work and clinic campus Accessible treatments No limits on number of attempts per year Not self-blaming- practice rather than failure

13 1-800-QUIT-NOW ( ) You have reached Press 1 for English How may I help you? On-line Enrollment July 2017 On-line Quit Coaching!!

14 Paper fax Electronic fax ereferral using CCD: HL7 v3 is required Technical Assistance is provided free to organizations Interface fee to National Jewish Health Hospital is covered by TPCP $9,000

Coaches Out reach calls are within 36 hours (1-800-784-8669) 3 calls in 3

15 Referrals to QuitWorks-NH are received at National Jewish Health Hospital s Call Center for Integrated Health-Denver Colorado Over 100 trained Quit Coaches Out reach calls are within 36 hours ( ) 3 calls in 3 days-they leave messages Feedback reports sent to the referring professional

16 Out reach calls show up as Auto-dialed then connected to Intake Specialist Split-second lag time with a click before Intake Specialist says anything 5 Minute Intake Screener must be completed before transferred to a Quit Coach There is a 30 second HOLD to connect to a Quit Coach

17 Choose a Hospital Unit or Office Practice Map current workflow for treating these patients Insert Quit Now NH into the workflow based on training and technical assistance from NH Tobacco Prevention and Cessation Program TRAIN STAFF on the new work flow Plan Do Study Act cycles

18 conversations-for-change-series

19 Teresa Brown

Asthma Educator Sharing Day October 28, 2016

Asthma Educator Sharing Day October 28, 2016 Tobacco Use vs. Asthma What Can I Do? Smoking and Asthma One of the biggest triggers of asthma. Every year in Michigan, over 1,740 non-smokers die as a result