Abstract
Tobacco use negatively impacts cancer treatment outcomes, yet too few providers actively support their patients in quitting. Barriers to consistently addressing tobacco use and referring to treatment include time constraints and lack of knowledge surrounding treatment options. Patient Reported Outcomes (PRO) measurement is best practice in cancer care and has potential to help address these barriers to tobacco cessation treatment. This descriptive program evaluation study reports preliminary results following implementation of a novel automated PRO tobacco use screener and referral system via the electronic health record (EHR) patient portal (MyChart) that was developed and implemented as a part of a population-based tobacco treatment program at the Robert H. Lurie Comprehensive Cancer Center of Northwestern University. Between 25 June 2019 and 6 April 2020, 4589 unique patients completed the screener and 164 (3.6%) unique patients screened positive for recent (past month) cigarette smoking. All patients who screened positive were automatically referred to a smoking cessation treatment program integrated within the Lurie Cancer Center, and 71 (49.7%) patients engaged in treatment, as defined by completing at least one behavioral counseling session. Preliminary results indicate that the PRO/MyChart system may improve smoker identification and increase offering of treatment and, despite the “cold call” following a positive screen, may result in a treatment engagement rate that is higher than rates of treatment engagement previously documented in oncology settings. Longer term evaluation with formal statistical testing is needed before drawing conclusions regarding effectiveness, but PRO measurement via the EHR patient portal may serve a potentially important role in a multi-component approach to reaching and engaging cancer patients in comprehensive tobacco cessation treatment.
Highlights
Continued smoking following a cancer diagnosis increases both cancer-specific and all-cause mortality [1]
The automated Patient Reported Outcomes (PRO) tobacco screener and referral system was implemented via the patient The automated
Only 40% of providers actively assist their patients with quitting or refer them to treatment, creating a critical missed opportunity [9,10]. This gap in cancer care is being addressed by Lurie Cancer Center and 41 other cancer centers under the NCI Cancer Moonshot Cancer Center
Summary
Continued smoking following a cancer diagnosis increases both cancer-specific and all-cause mortality [1]. Smoking is associated with adverse treatment outcomes and treatment related toxicity for patients undergoing chemotherapy, radiation, or surgery [2,3,4,5]. Res. Public Health 2020, 17, 5034; doi:10.3390/ijerph17145034 www.mdpi.com/journal/ijerph
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