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Randomized Controlled Trial
. 2007 Aug;22(8):1125-31.
doi: 10.1007/s11606-007-0232-2. Epub 2007 May 25.

Effectiveness of an on-call counselor at increasing smoking treatment

Scott E Sherman  1 , Maribel Estrada, Andy B Lanto, Melissa M Farmer, Ileana Aldana
Affiliations
Randomized Controlled Trial

Effectiveness of an on-call counselor at increasing smoking treatment

Scott E Sherman et al. J Gen Intern Med. 2007 Aug.

Abstract

Background: Smoking cessation programs are very effective, but little is known about how to get smokers to attend these programs.

Objective: To evaluate whether an "on-call" counselor increased smoking cessation program referrals and attendance.

Design: We randomly assigned 1 of 2 primary care teams at the Sepulveda VA Ambulatory Care Center to intervention and the other to usual care. The intervention team had access to an on-call counselor who provided counseling and care coordination. Social marketing efforts included educational outreach, provider feedback, and financial incentives.

Measurements: Baseline telephone interviews with a sample of 482 smokers were conducted, covering smoking history, health status, and smoking cessation treatments. Follow-up surveys were conducted at mid-intervention (n = 251) and post-intervention (n = 251).

Results: Two hundred ninety-six patients were referred to the on-call counselor, who counseled each patient in person and provided follow-up calls. The counselor referred 45% to the on-site program, and 27% to telephone counseling; of these, half followed through on the referral; 28% declined referral. Patients on the intervention team were more likely to report being counseled about smoking (68% vs 56%; odds ratio [OR] 1.7, CI 1.0-2.9) and referred to a cessation program (38% vs 23%; OR 2.1, CI 1.2-3.6); having attended the program (11% vs 4%; OR 3.6, CI 1.2-10.5); and receiving a prescription for bupropion (17% vs 8%) (OR 2.3, CI 1.1-5.1). The effect was not sustained after the case management period.

Conclusions: Having access to an on-call counselor with case management increased rates of smoking cessation counseling, referral, and treatment. The intervention could be reproduced by other health care systems.

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Figures

Figure 1
Figure 1
Overview of study intervention on the 2 primary care teams. SCC = Smoking Cessation Clinic.
Figure 2
Figure 2
Sampling diagram for population-based survey to evaluate intervention.
See this image and copyright information in PMC

References

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