Abstract
BackgroundTobacco use remains a leading cause of death and disability in the United States. Health professionals need to address the use of tobacco products by their patients, but chiropractic clinical systems often remain unsupported and underappreciated in their role to facilitate tobacco use cessation.MethodsThis pilot study tested an intervention to assist a chiropractic community to implement sustainable health systems changes for tobacco use based on U.S. Public Health Service guidelines. Chiropractors were educated on the Ask, Advise, Refer (AAR) approach, provided with ongoing guidance, and followed for six months to assess systems change. The study was conducted from March 2016 to July 2017.ResultsEvidence of a systematic process in place to conduct AAR was present in all clinics by the end of the fourth month of the intervention period. Although no clinic had sustained health system change for full AAR, all six of the clinics made progress in the individual AAR components. Furthermore, five clinics achieved sustained system change for the Ask component, as after systems change was achieved, the rate of tobacco user identifications did not drop below 50%. For the Advise component, five clinics succeeded in having individual months of ≥50% of tobacco users being advised, and three clinics achieved the formal definition of systems change. For the Refer component, no clinic achieved system change, although four had individual months of ≥50% of tobacco users being referred. The patient quit rate was 13.3% (n = 15) for the 30-day follow-up and 16.7% (n = 6) for the three-month follow-up.ConclusionsThis study demonstrates the feasibility of implementing a health systems change in the chiropractic setting to identify tobacco users, to advise them to quit, and to refer users for cessation services.
Highlights
Tobacco use remains a leading cause of death and disability in the United States
The chiropractors had been in practice for an average of 13 years, and four routinely screened patients for tobacco use prior to the study
Five clinics achieved sustained system change, as after systems change was achieved, the rate of tobacco user identifications did not drop below 50%
Summary
Tobacco use remains a leading cause of death and disability in the United States. Despite the steady decline in the prevalence of tobacco use, more than one in seven adults continue to use tobacco products, and tobacco-related illness remains the leading cause of preventable death in the United States [1]. Coordinated and systematic efforts to implement evidence-based tobacco control and cessation continue to undergo quality improvement [2,3,4,5]. The U.S Public Health Service provided evidence-based guidelines and support for health systems change to implement tobacco dependence treatment, including opportunities for clinician education [2]. Many adults utilize complementary and alternative medical therapies, some as an adjunct to conventional medicine and others as their primary source of health care. Chiropractic care comprises the largest provision of complementary health care in the United States [7]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
