261910 Comparison of paper referrals versus e-referrals of patients to a web-assisted tobacco intervention in dental practices: A Dental PBRN Study

Tuesday, October 30, 2012

Midge N. Ray, RN, MSN , Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, AL
Ellen Funkhouser, PhD , Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL
Jessica H. Williams, PhD , Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL
Heather L. Coley, MPH , Division of General Internal Medicine, University of Alabama at Birmingham, Birmingham, AL
Rajani S. Sadasivam, PhD , Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA
Gregg H. Gilbert, DDS, MBA , Department of General Dental Sciences, School of Dentistry, University of Alabama at Birmingham, Birmingham, AL
Kathryn DeLaughter, MA , Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA
Thomas K. Houston, MD, MPH , Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA
for the DPBRN Collaborative Group , The DPBRN Collaborative Group comprises practitioners, faculty and staff who contributed to this DPBRN activity., A list of these persons is at http://www.dpbrn.org/users/publications/Default.aspx, Birmingham, AL
BACKGROUND: Tobacco use remains the leading preventable cause of death and morbidity in the US. Web-based patient cessation resources are available to assist health care practitioners, but are under-utilized. The dental practice environment is well-positioned to assist patients in quitting through online resources. METHODS: We conducted a randomized controlled trial of 100 dental practices in The Dental Practice-Based Research Network (www.DentalPBRN.org) using direct patient referral to a quit-smoking website (Decide2Quit.org). Intervention practices referred patients via e-referral; Control practices used a written information prescription. We tested differences in referral rates between randomization groups and, among patients referred, differences in patient registration rates, adjusting for potential confounders. RESULTS: A total of 1,120 and 689 smokers were referred by Control and Intervention practices, respectively; [adjusted] p<0.001. Means of 23 patients (Control) vs. 13 (Intervention) were referred per practice, [adjusted] p<0.001. Of patients referred to Decide2Quit, more Intervention than Control patients registered (26 vs. 6.4 per practice, [adjusted] p<0.001). CONCLUSIONS: Despite receiving feedback on individual referral rates and the average rates of their peers, Intervention practices referred fewer patients than Control. However, once referred, more Intervention patients registered on Decide2Quit. Dental providers were less likely to adopt electronic referrals, but patient website registrations were substantially higher with this direct linkage to cessation resources, offering a promising mechanism to increase patients' access to cessation resources.

Learning Areas:
Conduct evaluation related to programs, research, and other areas of practice
Other professions or practice related to public health
Provision of health care to the public

Learning Objectives:
Identify the advantages of an electronic referral system for patient access to an online quit-smoking intervention. Compare two strategies to connect dental patients with web-assisted tobacco cessation resources.

Keywords: Smoking Cessation, Tobacco Control

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Ms. Ray is an Associate Professor in the Department of Health Services Administration at University of Alabama at Birmingham and a Scientist in the Center for Outcomes and Effectiveness Research. She has served as principal investigator and co-investigator on multiple federally funded grants, three of which involve tobacco cessation. Most of her research has been involved with using technology to facilitate use of the tobacco control guidelines in physician and dental practices.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4159.0: Online Tobacco Programming: High Tech? High Touch?