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Provider feedback improves adherence with AHCPR Smoking Cessation Guideline.
Prev Med. 2001 Nov; 33(5):415-21.PM

Abstract

BACKGROUND

This study evaluated the effect of primary care providers' adherence with the AHCPR Smoking Cessation Guideline after receiving a multicomponent intervention.

METHODS

A quasi-experimental study with one intervention and one control team was conducted in a southeastern Veterans Affairs Medical Center primary care setting. During phase I, chart reviews were conducted to measure baseline provider adherence and documentation of the four A's (ask, advise, assist, arrange). In phase II, the intervention team received a single educational session on the AHCPR Guideline, four A's, and tobacco dependence treatment. This was followed by chart reviews of patients seen 4 to 8 weeks after the educational intervention to measure provider adherence and documentation of the four A's. During phase III, the intervention team received individual and team feedback from the chart reviews in phases I and II and booster education on the AHCPR Guideline. Chart reviews were conducted from patient visits 4 to 8 weeks after the feedback and booster education to determine provider adherence and documentation of the four A's.

RESULTS

A nested repeated measures two-factor analysis of variance was performed for each of the following outcomes: ask, advise, assist, and arrange. Data analyses revealed that both the control and the intervention teams had 100% compliance in asking the patient about smoking status. There was a prestudy implementation of the vital sign stamp that included smoking status in this setting. Education on tobacco dependence and the AHCPR Guideline had no significant impact on provider performance with the advisement, assistance, and arrangement of follow-up. However, significant improvements occurred in the intervention team in the advisement (P = 0.05), assistance (P = 0.001), and arrangement of follow-up (P = 0.001) phase after individual and team feedback was provided. This research supports the fact that feedback impacts individuals and team performances and facilitated positive system changes to improve provider adherence with the AHCPR recommendations in treating tobacco dependence.

Authors+Show Affiliations

Department of Community Nursing, Medical College of Georgia, Augusta 30912, USA. jandrews@mail.mcg.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

11676582

Citation

Andrews, J O., et al. "Provider Feedback Improves Adherence With AHCPR Smoking Cessation Guideline." Preventive Medicine, vol. 33, no. 5, 2001, pp. 415-21.
Andrews JO, Tingen MS, Waller JL, et al. Provider feedback improves adherence with AHCPR Smoking Cessation Guideline. Prev Med. 2001;33(5):415-21.
Andrews, J. O., Tingen, M. S., Waller, J. L., & Harper, R. J. (2001). Provider feedback improves adherence with AHCPR Smoking Cessation Guideline. Preventive Medicine, 33(5), 415-21.
Andrews JO, et al. Provider Feedback Improves Adherence With AHCPR Smoking Cessation Guideline. Prev Med. 2001;33(5):415-21. PubMed PMID: 11676582.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Provider feedback improves adherence with AHCPR Smoking Cessation Guideline. AU - Andrews,J O, AU - Tingen,M S, AU - Waller,J L, AU - Harper,R J, PY - 2001/10/26/pubmed PY - 2002/1/5/medline PY - 2001/10/26/entrez SP - 415 EP - 21 JF - Preventive medicine JO - Prev Med VL - 33 IS - 5 N2 - BACKGROUND: This study evaluated the effect of primary care providers' adherence with the AHCPR Smoking Cessation Guideline after receiving a multicomponent intervention. METHODS: A quasi-experimental study with one intervention and one control team was conducted in a southeastern Veterans Affairs Medical Center primary care setting. During phase I, chart reviews were conducted to measure baseline provider adherence and documentation of the four A's (ask, advise, assist, arrange). In phase II, the intervention team received a single educational session on the AHCPR Guideline, four A's, and tobacco dependence treatment. This was followed by chart reviews of patients seen 4 to 8 weeks after the educational intervention to measure provider adherence and documentation of the four A's. During phase III, the intervention team received individual and team feedback from the chart reviews in phases I and II and booster education on the AHCPR Guideline. Chart reviews were conducted from patient visits 4 to 8 weeks after the feedback and booster education to determine provider adherence and documentation of the four A's. RESULTS: A nested repeated measures two-factor analysis of variance was performed for each of the following outcomes: ask, advise, assist, and arrange. Data analyses revealed that both the control and the intervention teams had 100% compliance in asking the patient about smoking status. There was a prestudy implementation of the vital sign stamp that included smoking status in this setting. Education on tobacco dependence and the AHCPR Guideline had no significant impact on provider performance with the advisement, assistance, and arrangement of follow-up. However, significant improvements occurred in the intervention team in the advisement (P = 0.05), assistance (P = 0.001), and arrangement of follow-up (P = 0.001) phase after individual and team feedback was provided. This research supports the fact that feedback impacts individuals and team performances and facilitated positive system changes to improve provider adherence with the AHCPR recommendations in treating tobacco dependence. SN - 0091-7435 UR - https://www.unboundmedicine.com/medline/citation/11676582/Provider_feedback_improves_adherence_with_AHCPR_Smoking_Cessation_Guideline_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0091-7435(01)90907-7 DB - PRIME DP - Unbound Medicine ER -