Are we failing to document adequate smoking histories? A brief review 1999–2009

Self, Timothy H.; Wallace, Jessica L.; Gray, Lori Arnold; Usery, Justin B.; Finch, Christopher K.; Deaton, Paul R.

doi:10.1185/03007995.2010.486574

Cited by 12 publications

(9 citation statements)

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“…Some of the problems of electronic databases are well known: underreporting during the first years of implementation, variability resulting from heterogeneity in coding, using open-text fields to record activity without linking it to a diagnosis, etc. [ 18 , 35 , 38 , 39 ]. All of these may explain disparities between studies.…”

Section: Discussionmentioning

confidence: 99%

“…It was based on a registry of daily clinical activity at the point when computerization of PHC health records had just begun to mature. The acquisition of good recording habits and the changes that occurred in the software over time could have affected the recording of clinical activity [ 39 , 47 ]. Finally, available programs did not allow adequate recording of the activities conducted by nursing professionals, despite their important role in prevention [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

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Variability in screening prevention activities in primary care in Spain: a multilevel analysis

et al. 2015

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BackgroundDespite evidence of the benefits of prevention activities, studies have reported only partial integration and great variability of screening in daily clinical practice. The study objectives were: 1) To describe Primary Health Care (PHC) screening for arterial hypertension, dyslipidaemia, obesity, tobacco use, and excessive alcohol consumption in 2008 in 2 regions of Spain, based on electronic health records, and 2) To assess and quantify variability in screening, and identify factors (of patient, general practitioners and PHC team) associated with being screened, that are common throughout the PHC population.MethodsMulticentre, cross-sectional study of individuals aged ≥16 years (N = 468,940) who visited the 426 general practitioners (GPs) in 44 PHC teams in Catalonia and Navarre in 2008. Outcomes: screening for hypertension, dyslipidaemia, obesity, tobacco use, and excessive alcohol consumption. Other variables were considered at the individual (sociodemographics, visits, health problems), GP and PHC team (region among others). Individual and contextual factors associated with the odds of being screened and the variance attributable to each level were identified using the SAS PROC GLIMMIX macro.ResultsThe most prevalent screenings were for dyslipidaemia (64.4%) and hypertension (50.8%); the least prevalent was tobacco use (36.6%). Overall, the odds of being screened were higher for women, older patients, those with more comorbidities, more cardiovascular risk factors, and more frequent office visits, and those assigned to a female GP, a GP with a lower patient load, or a PHC team with a lower percentage of patients older than 65 years. On average, individuals in Navarre were less likely to be screened than those in Catalonia. Hypertension and dyslipidaemia screenings had the least unexplained variability between PHC teams and GPs, respectively, after adjusting for individual and contextual factors.ConclusionsOf the studied screenings, those for obesity, tobacco, and alcohol use were the least prevalent. Attention to screening, especially for tobacco and alcohol, can be greatly improved in the PHC setting.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-1767-5) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Variability in screening prevention activities in primary care in Spain: a multilevel analysis

et al. 2015

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“…The quality of the smoking history within the EHR impacts the success of these approaches. 48 Order sets can be built to include reminders about the accepted screening criteria within them. Patient education tools in the form of pamphlets, call-lines, internet resources, and letters can be considered in conjunction with marketing experts.…”

Section: How To Identify the Proper Risk Groupmentioning

confidence: 99%

Obstacles to and Solutions for a Successful Lung Cancer Screening Program

Mazzone

2016

Semin Respir Crit Care Med

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Lung cancer screening with a low radiation dose chest CT scan has been shown to reduce the number of people, in a well-defined very high-risk cohort, who die from lung cancer. Many potential screening-related harms have been identified, including anxiety and morbidity related to the evaluation of screen-detected findings. A favorable balance of the benefit and harms of lung cancer screening requires careful implementation of a screening program, with a focus on several obstacles to the success of the program. In this review, evidence to support the benefit and harms of lung cancer screening is provided, followed by a discussion of 11 obstacles to the development of a high-quality program. For each obstacle, an approach is suggested, based on evidence and mandates as well as practicality and lessons learned. The approach to each of these obstacles highlights the multi-disciplinary nature of lung cancer screening, and the value of considering lung cancer screening a program rather than a test.

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“…Además, de los resultados se deduce que la exposición de los pacientes de atención primaria al tabaco en el puesto de trabajo, así como la de los controles en el hogar, supera la exposición de la población general. Conviene, pues, alertar al médico sobre la importancia del tabaquismo de segunda mano entre sus pacientes y la necesidad de documentarlo adecuadamente en la historia clínica 23 .…”

Section: Discussionunclassified

Aplicación de la Escala de Tabaquismo para Atención Primaria (ETAP) en la práctica clínica

et al. 2018

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Are we failing to document adequate smoking histories? A brief review 1999–2009

Abstract: Failure to adequately document the smoking history appears to be common. Strategies such as electronic decision support systems are needed to correct this problem in order for patients to receive optimal therapy for their appropriate diagnoses.

Cited by 12 publications

References 20 publications

Variability in screening prevention activities in primary care in Spain: a multilevel analysis

Variability in screening prevention activities in primary care in Spain: a multilevel analysis

Obstacles to and Solutions for a Successful Lung Cancer Screening Program

Aplicación de la Escala de Tabaquismo para Atención Primaria (ETAP) en la práctica clínica

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