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Quitline treatment dose predicts cessation outcomes among safety net patients linked with treatment via Ask-Advise-Connect
- Source :
- Preventive Medicine Reports, Preventive Medicine Reports, Vol 13, Iss, Pp 262-267 (2019)
- Publication Year :
- 2019
- Publisher :
- Elsevier BV, 2019.
-
Abstract
- The efficacy of tobacco treatment delivered by state quitlines in diverse populations is well-supported, yet little is known about associations between treatment dose and cessation outcomes following the implementation of Ask-Advise-Connect (AAC), an electronic health record-based systematic referral process that generates a high volume of proactive calls from the state quitline to smokers. The current study is a secondary analysis of a 34-month implementation trial evaluating ACC in 13 safety-net clinics in Houston, TX. Treatment was delivered by a quitline and comprised up to five proactive, telephone-delivered multi-component cognitive-behavioral treatment sessions. Associations between treatment dose and abstinence were examined. Abstinence was assessed by phone six months after treatment enrollment, and biochemically confirmed via mailed saliva cotinine. Among smokers who enrolled in treatment and agreed to follow-up (n = 3704), 29.2% completed no treatment sessions, 35.5% completed one session, 16.4% completed two sessions, and 19.0% completed ≥three sessions. Those who completed one (vs. no) sessions were no more likely to report abstinence (OR: 0.98). Those who completed two (vs. no) sessions were nearly twice as likely to report abstinence (OR: 1.83). Those who completed ≥three (vs. no) sessions were nearly four times as likely to report abstinence (OR: 3.70). Biochemically-confirmed cessation outcomes were similar. Most smokers received minimal or no treatment, and treatment dose had a large impact on abstinence. Results highlight the importance of improving engagement in evidence-based treatment protocols following enrollment. Given that motivation to quit fluctuates, systematically offering enrollment to all smokers at all visits is important.<br />Highlights • The majority of smokers received minimal or no evidence-based tobacco treatment. • Smokers who completed 0 or 1 treatment sessions were unlikely to achieve abstinence. • Completion of 2 calls doubled the likelihood of abstinence at 6 months. • Completion of ≥3 calls was associated with a near quadrupling of abstinence rates. • Improving engagement in evidence-based treatment protocols is a research priority.
- Subjects :
- medicine.medical_specialty
Electronic health record
medicine.medical_treatment
media_common.quotation_subject
Quitline
lcsh:Medicine
Ask-Advise-Connect
030209 endocrinology & metabolism
Health Informatics
Smoking cessation
Session (web analytics)
03 medical and health sciences
chemistry.chemical_compound
Telephone counseling
0302 clinical medicine
Tobacco
medicine
030212 general & internal medicine
media_common
business.industry
lcsh:R
Public Health, Environmental and Occupational Health
Regular Article
Abstinence
3. Good health
chemistry
Treatment dose
Physical therapy
Cotinine
business
Subjects
Details
- ISSN :
- 22113355
- Volume :
- 13
- Database :
- OpenAIRE
- Journal :
- Preventive Medicine Reports
- Accession number :
- edsair.doi.dedup.....d1d446f34df350fb27cae6c18e8e8898