Documentation of the 5 As for smoking cessation by PCPs across distinct health systems

Rebecca J. Williams, Andrew L. Masica, Mary Ann McBurnie, Leif I. Solberg, Steffani Bailey, Brian Hazlehurst, Stephen E. Kurtz, Andrew E. Williams, Jon E. Puro, Victor J. Stevens

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objectives: Physicians can help patients quit smoking using the 5 As of smoking cessation. This study aimed to (1) identify the proportion of known smokers that receive smoking cessation services in the course of routine clinical practice; (2) describe demographic and comorbidity characteristics of patients receiving the 5 As in these systems; and (3) evaluate differences in performance of the 5 As across health systems, gender, and age categories. Study Design: Electronic medical records of 200 current smokers from 6 unique health systems (N = 1200) were randomly selected from 2006 to 2010. Primary care encounter progress notes were hand coded for occurrences of the 5 As. Methods: Bivariate comparisons of delivery of the 3 smoking-cessation services by site, gender, and age category were analyzed using χ2 tests. Results: About 50% of smokers were advised to quit smoking, 39% were assessed for their readiness to quit, and 54% received some type of assistance to help them quit smoking. Only 2% had a documented plan for follow-up regarding their quitting efforts (arrange). Significant differences were found among sites for documentation of receiving the 5 As and between age groups receiving assistance with quitting. There was no statistically significant difference between genders in receipt of the 5 As. Conclusions: Documentation of adherence to the 5 As varied by site and some demographics. Adjustments to protocols for addressing cessation and readiness to quit may be warranted. Health systems could apply the methodology described in this paper to assess their own performance, and then use that as a basis to guide improvement initiatives.

Original languageEnglish (US)
JournalAmerican Journal of Managed Care
Volume20
Issue number3
StatePublished - 2014

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Smoking Cessation
Documentation
Smoking
Health
Demography
Social Adjustment
Electronic Health Records
Comorbidity
Primary Health Care
Hand
Age Groups
Physicians

ASJC Scopus subject areas

  • Health Policy

Cite this

Williams, R. J., Masica, A. L., McBurnie, M. A., Solberg, L. I., Bailey, S., Hazlehurst, B., ... Stevens, V. J. (2014). Documentation of the 5 As for smoking cessation by PCPs across distinct health systems. American Journal of Managed Care, 20(3).

Documentation of the 5 As for smoking cessation by PCPs across distinct health systems. / Williams, Rebecca J.; Masica, Andrew L.; McBurnie, Mary Ann; Solberg, Leif I.; Bailey, Steffani; Hazlehurst, Brian; Kurtz, Stephen E.; Williams, Andrew E.; Puro, Jon E.; Stevens, Victor J.

In: American Journal of Managed Care, Vol. 20, No. 3, 2014.

Research output: Contribution to journalArticle

Williams, RJ, Masica, AL, McBurnie, MA, Solberg, LI, Bailey, S, Hazlehurst, B, Kurtz, SE, Williams, AE, Puro, JE & Stevens, VJ 2014, 'Documentation of the 5 As for smoking cessation by PCPs across distinct health systems', American Journal of Managed Care, vol. 20, no. 3.
Williams, Rebecca J. ; Masica, Andrew L. ; McBurnie, Mary Ann ; Solberg, Leif I. ; Bailey, Steffani ; Hazlehurst, Brian ; Kurtz, Stephen E. ; Williams, Andrew E. ; Puro, Jon E. ; Stevens, Victor J. / Documentation of the 5 As for smoking cessation by PCPs across distinct health systems. In: American Journal of Managed Care. 2014 ; Vol. 20, No. 3.
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abstract = "Objectives: Physicians can help patients quit smoking using the 5 As of smoking cessation. This study aimed to (1) identify the proportion of known smokers that receive smoking cessation services in the course of routine clinical practice; (2) describe demographic and comorbidity characteristics of patients receiving the 5 As in these systems; and (3) evaluate differences in performance of the 5 As across health systems, gender, and age categories. Study Design: Electronic medical records of 200 current smokers from 6 unique health systems (N = 1200) were randomly selected from 2006 to 2010. Primary care encounter progress notes were hand coded for occurrences of the 5 As. Methods: Bivariate comparisons of delivery of the 3 smoking-cessation services by site, gender, and age category were analyzed using χ2 tests. Results: About 50{\%} of smokers were advised to quit smoking, 39{\%} were assessed for their readiness to quit, and 54{\%} received some type of assistance to help them quit smoking. Only 2{\%} had a documented plan for follow-up regarding their quitting efforts (arrange). Significant differences were found among sites for documentation of receiving the 5 As and between age groups receiving assistance with quitting. There was no statistically significant difference between genders in receipt of the 5 As. Conclusions: Documentation of adherence to the 5 As varied by site and some demographics. Adjustments to protocols for addressing cessation and readiness to quit may be warranted. Health systems could apply the methodology described in this paper to assess their own performance, and then use that as a basis to guide improvement initiatives.",
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