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Mobile technology reminds clinicians about tobacco counseling

Monday April 14, 2014
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Smartphones and tablets may hold the key to getting more clinicians to screen patients for tobacco use and advise smokers on how to quit, according to a study.

Even though tobacco use is the leading cause of preventable disease and death in the U.S., patients are screened for tobacco use in about 60% of office visits, and smokers are advised on how to quit less than 20% of the time, according to the CDC.

Using mobile phones loaded with tobacco screening guidelines prompted nurses to ask patients about their smoking habits in 84% of clinic visits and to offer cessation counseling to 99% of smokers who expressed a willingness to kick the habit, researchers with the Columbia University School of Nursing in New York City reported in the March issue of the journal Oncology Nursing Forum.

“These findings suggest that mobile applications can play a significant role in curbing tobacco use,” lead study author Kenrick Cato, RN, PhD, associate research scientist at Columbia Nursing, said in the news release.

“These findings are a win in the ongoing battle against tobacco use, and they also point to a broader benefit of mobile applications in getting more clinicians to follow evidence-based practice guidelines,” Cato says.

The study evaluated tobacco screening rates for more than 14,000 visits at clinics in New York City. Clinic patients were treated by 185 RNs enrolled in advanced practice degree programs at Columbia Nursing.

While overall screening and counseling rates were increased by use of the mobile tools, the gains varied by race, gender and payer source, the study found. Screening was more likely to occur when patients were female or African American and at clinics where the predominant payer source was Medicare, Medicaid or the State Children’s Health Insurance Program. Screening also was more likely for patients with private insurance than for patients who were uninsured or covered by worker compensation benefits, the study found.

“Screening for African Americans, and men in particular, has traditionally lagged other populations, and the higher screening rates that we found for African Americans suggest that mobile health-decision tools can help address health disparities,” Cato said. “The technology can serve to remove any unintended bias clinicians might have about which patients are most likely to benefit from intervention.”

While the study included only patients seen by nurses who had access to mobile health tools, the screening and counseling rates in the study are much higher than the baseline rates tracked by the CDC, Cato said. Using the mobile tools also helped clinicians exceed the targets for screening and counseling established by Healthy People 2020, a national road map for improving health and eliminating health disparities. Tobacco-related objectives in Healthy People 2020 include screening rates of about 69% and counseling rates of about 21% during office visits.

Study abstract: http://bit.ly/1qJI7jB


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