Physician-directed smoking cessation using patient "opt-out" approach in the emergency department: A pilot program.
Publication/Presentation Date
10-1-2020
Abstract
Objective: Using a physician-directed, patient "opt-out" approach to prescriptive smoking cessation in the emergency department (ED) setting, we set out to describe patient actions as they related to smoking cessation behaviors.
Methods: A convenience sample of smokers at 2 Pennsylvania hospital EDs who met inclusion/exclusion criteria were approached to participate in a brief intervention known as screening, treatment initiation, and referral (STIR) counseling that included phone follow-up. Demographic information, current smoking status, and specific physician prescription and follow-up recommendations were collected. Approximately 3 months later, patients were contacted to determine current smoking status and actions taken since their ED visit.
Results: One hundred six patients were approached and 7 (6.6%) opted out of the intervention. Patients who did not opt out were evaluated for appropriate use of smoking cessation-related medications; 35 (35.4%) opted out of the prescription(s) and 6 (6.1%) were not indicated. Twenty-one (21.2%) patients opted out of ambulatory referral follow-ups with primary care and/or tobacco treatment program; one (1.0%) was not indicated for referral. Nineteen (32.8%) patients who received prescription(s) for smoking cessation-related medications initially also followed the prescription(s). Seventeen (22.1%) patients participated in referral follow-up.
Conclusion: In this small ED pilot, using the STIR concepts in an opt-out method, few smokers opted out of the smoking cessation intervention. About one-third of the patients declined prescriptions for smoking cessation-related medications and less than one-quarter declined ambulatory referrals for follow-up. These findings support a willingness of patients to participate in STIR and the benefits of intervention in this setting.
Volume
1
Issue
5
First Page
782
Last Page
789
ISSN
2688-1152
Published In/Presented At
Greenberg, M. R., Greco, N. M., Batchelor, T. J., Miller, A., Doherty, T., Aziz, A. S., Yee, S. Z., Arif, F., Crowley, L. M., Casey, E. W., & Kruklitis, R. J. (2020). Physician-directed smoking cessation using patient "opt-out" approach in the emergency department: A pilot program. Journal of the American College of Emergency Physicians open, 1(5), 782–789. https://doi.org/10.1002/emp2.12176
Disciplines
Emergency Medicine | Medicine and Health Sciences
PubMedID
33145519
Peer Reviewed for front end display
Peer-Reviewed
Department(s)
Department of Emergency Medicine, Department of Emergency Medicine Faculty, Department of Emergency Medicine Residents, Department of Medicine, Department of Medicine Faculty, USF-LVHN SELECT Program, USF-LVHN SELECT Program Faculty, USF-LVHN SELECT Program Students
Document Type
Article