Cluster-randomized trial of a web-assisted tobacco quality improvement intervention of subsequent patient tobacco product use: a National Dental PBRN study

Thomas K Houston,Catarina I Kiefe,Kathryn L Delaughter,Gregg H Gilbert,Jeroan J Allison,Julie E Volkman,Midge N Ray

doi:10.1186/1472-6831-13-13

Abstract

BackgroundBrief clinician delivered advice helps in tobacco cessation efforts. This study assessed the impact of our intervention on instances of advice given to dental patients during visits on tobacco use quit rates 6 months after the intervention.MethodsThe intervention was cluster randomized trial at the dental practice level. Intervention dental practices were provided a longitudinal technology-assisted intervention, oralcancerprevention.org that included a series of interactive educational cases and motivational email cues to remind dental provides to complete guideline-concordant brief behavioral counseling at the point of care. In all dental practices, exit cards were given to the first 100 consecutive patients, in which tobacco users provided contact information for a six month follow-up telephone survey.ResultsA total of 564 tobacco using dental patients completed a six month follow-up survey. Among intervention patients, 55% reported receiving advice to quit tobacco, and 39% of control practice patients reported receiving advice to quit tobacco (p < 0.01). Six-month tobacco use quit rates were not significantly between the Intervention (9%) and Control (13%) groups, (p = 0.088).ConclusionAlthough we increased rates of cessation advice delivered in dental practices, this study shows no evidence that brief advice by dentist’s increases long-term abstinence in smokers.Trial registrationClinicalTrials.gov NCT00627185

Highlights

Brief clinician delivered advice helps in tobacco cessation efforts
Study design We conducted a cluster-randomized trial (2005–2008) to evaluate www.dtc.cme.uab.edu, a web-assisted tobacco control quality improvement program designed to increase the quality and quantity of tobacco product cessation advice delivered at the point of care by dental providers
After adjusting for clustering of tobacco users within dental practices, and adjusting for patient self-reported health, a variable significantly different in the intervention and control, we found no difference in the six-month follow-up report of tobacco use cessation, comparing intervention and control group

Summary

Introduction

This study assessed the impact of our intervention on instances of advice given to dental patients during visits on tobacco use quit rates 6 months after the intervention. Despite widespread acceptance that tobacco use is the primary preventable cause of death; rates of this risky behavior have not substantially declined in the past decade [1]. The dental visit represents a unique opportunity for tobacco control, for a variety of reasons. First and especially in today’s economic climate, some tobacco users do not regularly visit medical providers, but may seek dental care for routine cleanings and cosmetic reasons [5]. As tobacco use causes cosmetic and oral health problems, smokers may be concentrated in this population seeking dental, but not medical care

Methods

Results

Discussion

Conclusion