The study used health plan administrative data and audit of medical charts from four primary care practices in Maine to evaluate provider performance in identifying and treating patients who smoke. Two office sessions were conducted. Data was presented during the first educational session at the medical office, following a brief presentation about tobacco dependence and treatment. Graphic data feedback was presented, showing tobacco-related chart documentation, claims for nicotine replacement and bupropion, and claims for diagnostic coding for tobacco use among adult patients enrolled in two health plans. The second session focused on implementation of the PHS Guidelines and challenges to office system changes.

For each profiling measure examined, there were significant variations within practices and between practices. Sixty-eight percent of the participating providers said that the sessions increased their knowledge about tobacco use and treatment, and 66 percent felt the sessions increased their routine identification of tobacco use. However, only 44 percent agreed that data feedback would improve their ability to interact with tobacco users. This study concludes that academic profiling for tobacco treatment will be useful if it can be done cost-effectively, if there is a perceived value of the education and feedback, and, ultimately, if practice performance is improved. A randomized trial of academic profiling to increase tobacco intervention, funded by AHRQ, is currently underway.

Citations:

Swartz SH, Cowan TM, DePue J, Goldstein MG. Academic profiling of tobacco-related performance measures in primary care. Nicotine Tob Res 2002;4(Suppl 1):S38-S44.

For more information, contact:

Susan Swartz, MD, MPH
Medical Director, Center for Tobacco Independence
Maine Medical Center
22 Bramhall Street
Portland, ME 04102