Abstract
BackgroundWell established clinical guidelines recommend that systematic ascertainment of smoking status and intervention to promote cessation in all smokers should be a fundamental component of all health care provision. This study aims to establish the completeness and accuracy of smoking status recording in patients' primary care medical records and the level of interest in receiving smoking cessation support amongst primary care patients in an inner city UK population.MethodsPostal questionnaires were sent to all patients aged over 18 from 24 general practices in Nottingham UK who were registered as smokers or had no smoking status recorded in their medical notes.ResultsThe proportion of patients with a smoking status recorded varied between practices from 42.4% to 100% (median 90%). Of the recorded smokers who responded to our questionnaire (35.5% of the total), a median of 20.3% reported that they had not smoked cigarettes or tobacco in the last 12 months. Of respondents with no recorded smoking status, 29.8% reported themselves to be current smokers. Of the 6856 responding individuals thus identified as current smokers, 41.4% indicated that they would like to speak to a specialist smoking adviser to help them stop smoking. This proportion increased with socioeconomic disadvantage (measured by the Townsend Index) from 39.1% in the least deprived to 44.6% in the most deprived quintile.ConclusionWhilst in many practices the ascertainment of smoking status is incomplete and/or inaccurate, failure to intervene appropriately on known status still remains the biggest challenge.Trial registrationCurrent Controlled Trials ISRCTN71514078.
Highlights
Well established clinical guidelines recommend that systematic ascertainment of smoking status and intervention to promote cessation in all smokers should be a fundamental component of all health care provision
Data were collected from patients who were registered with 24 general practices in Nottinghamshire which participated in a cluster randomised controlled trial of a new approach to provision of smoking cessation services (ISRCTN71514078)
Respondents recorded as smokers in their medical records were more likely to respond than those with no smoking status recorded [35.5% (8176/23044) and 24.2% (2951/12188) respectively], and males and younger patients were less likely to respond to the questionnaire (Table 1)
Summary
Well established clinical guidelines recommend that systematic ascertainment of smoking status and intervention to promote cessation in all smokers should be a fundamental component of all health care provision. That the recording of smoking status in primary care medical records is often inaccurate [4,5] and that it is probably updated infrequently [4,5]. This limits the utility of smoking status recorded in patients' medical records for either clinical practice or for determining smoking prevalence within practices [4,5]. As this contract has increased the frequency with which GPs ascertain patients' smoking status [6], the completeness and accuracy of smoking status data in such records may have improved
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