EVALUATING PULMONARY/CRITICAL CARE FELLOWS’ PRACTICE HABITS REGARDING NICOTINE USE AFTER IMPLEMENTING A NOVEL INTERNET-BASED EDUCATIONAL SERIES

Abstract

SESSION TITLE: Tobacco Cessation and Prevention Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: Smoking remains the leading preventable cause of death in the US. Pulmonologists are positioned to identify nicotine use disorders and intervene with evidence-based treatments. However, limited education exists for pulmonary/critical care medicine (PCCM) trainees on this topic. This quality improvement project aimed to evaluate PCCM fellows’ practice patterns regarding nicotine use disorders after introducing an internet-based educational series. METHODS: At a single, academic US fellowship program PCCM fellows were introduced to a videocast series on nicotine use disorders. We performed a retrospective chart review of select PCCM fellow outpatient encounters at a large university-based practice during two timeframes: (i) pre-intervention period (3 months immediately prior), (ii) post-intervention period (3 months immediately after). We manually reviewed the electronic medical record for each encounter including social history, progress note, diagnostic codes, prescriptions, and patient instructions. Information reviewed included whether any care team member addressed nicotine history, fellow addressed nicotine history, patient was an active nicotine user, pack-year history was documented, diagnostic code used, prescription provided for nicotine use treatment, and referral was provided to quit-line and/or nicotine use treatment specialist. RESULTS: A total of 7 fellows were included in the analysis and chart review. 377 fellow outpatient encounters were reviewed, including 195 pre- and 182 post-intervention period encounters. Overall, a nicotine history was obtained by the collective care team in 99.2% of encounters, in which 58.0% of active nicotine users had documented “pack-year” history and 41.9% with diagnostic codes. Notably, after implementing education series, there was a statistically significant increase in the number of outpatient encounters in which the fellow captured information about patient nicotine use (66.7% vs 76.3%, p<0.05). There was a non-significant increase in treatments prescribed in the post-intervention group (41.9% vs 51.6%, p=0.45). CONCLUSIONS: In conclusion, we demonstrated that implementation of an online educational series to PCCM fellows resulted in a measurable increase the proportion of outpatient encounters in which the fellow captured history of nicotine use. There were no significant differences found in the reported “pack-year” history, diagnostic codes, and prescriptions for treatment, likely due to our small cohort. Such novel-based curricula should be evaluated in larger cohorts including repeated educational reinforcement. CLINICAL IMPLICATIONS: By implementing a brief online educational series on nicotine use disorders for fellows in-training, fellows can capture nicotine use in a higher proportion of patients. Further efforts should be explored in educating providers regarding nicotine use treatment and referrals. DISCLOSURES: No relevant relationships by Janaki Deepak, source=Web Response No relevant relationships by Jason Stankiewicz, source=Web Response No relevant relationships by Avelino Verceles, source=Web Response