Re: [Gnumed-devel] Smoking status - revised.

[Karsten Hilbert]

On Sun, Jan 30, 2011 at 05:18:22PM -0800, Jim Busser wrote:

> >> The other problem is how to support the possibility that a long list
> >> of things will each have different importance to different doctors to
> >> be able to easily see in each patient's record:
> >> 
> >> - …
> >> - smokes
> > 
> 
> From
> 
>       http://www.nbatc.ca/documents/Quitlinesforsmokingcessation.pdf
> 
>       EMRs can be used to remind clinicians to document
>   smoking status, deliver brief advice, prompt for
>   prescription of cessation medications, and facilitate
>   referrals to counselling. Linder et al36 performed a
>   cluster-randomized, controlled trial in 26 primary-care
>   practices over 10 months examining an EMR-based intervention
>   to improve cessation treatment in this setting. They
>   developed and implemented a 3-part EMR enhancement that
>   included smoking-status icons, cessation-treatment
>   reminders, and a form to facilitate medication prescriptions
>   as well as fax and e-mail counselling referrals. The primary
>   outcome was the proportion of documented smokers who made
>   contact with a smoking-cessation counsellor. They found
>   that, although the prescriptions for cessation medications
>   were the same in both treatment and control groups, the
>   EMR-based system improved smoking-status documentation and
>   increased counselling assistance to smokers.

Jim, that's great research you are doing here.

We might want to add a Wiki page "Clinical How To's".

One such How To could be "Motivating patients to quit
smoking" and would include:

- a link to the above
- how to manage the "smokes" tag in GNUmed
- how to write a hook script reminding the provider of
  the "need" to bring up cessation, that script could
  show a reminder whenever a patient with the tag is
  activated

Karsten
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