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The 13th World Conference on Tobacco OR Health

Building capacity for a tobacco-free world

July 12-15, 2006, Washington, DC, USA

Thursday, July 13, 2006 - 12:00 PM

Promoting Tobacco Cessation in Health Care Delivery: Integrating Fax Referrals into Pediatric Practice

Cindy Tworek, PhD, MPH1, Susan Swartz, MD, MPH1, Steve DiGiovanni, MD2, and Karen Wathen, MPPM3. (1) Maine Medical Center, Center for Tobacco Independence, 22 Bramhall St., Portland, ME 04102, (2) Bayview Pediatrics, 45 Forest Falls Drive, #A1, Yarmouth, ME 04096, (3) Glenwood Research, 35 Deake Street, South Portland, ME 04106

Objective: The Maine Tobacco HelpLine provides counseling and nicotine replacement therapy, and allows health providers to initiate fax referrals, connecting patients with HelpLine services. As a provider network, the Maine Medical Center Physician Health Organization (MMCPHO) began integrating HelpLine fax referrals with pediatric asthma practices in January 2005. Practices documented tobacco use, assessed quitting interest, and offered fax referrals for patient and household tobacco users. Frequent health care encounters became intervention opportunities, and practice participation was encouraged by informational mailings, small monetary incentives, clinical outreach visits, and education. Evaluating fax referral integration and feasible health care implementation are important to promote patient and household cessation efforts.

Methods: Data were collected from MMCPHO clinical improvement registries that track and report tobacco status, quitting interest, and past year treatment for patient and household tobacco use. Greater Portland had 19 pediatric family practice sites reporting tobacco measures through October 2005. Each site had at least 9 asthma patients, aged 2-18 years.

Results: Participating sites had 3,533 pediatric asthma patients. Patient tobacco status was documented for 75%, with 34 (1.3%) current patient tobacco users: 26.5% received past year tobacco treatment; 11.7% expressed quitting interest; and 6% consented to fax referrals. Household tobacco status was documented for 71%, with 421 (16.7%) current household tobacco users: 21.8% received past year tobacco treatment; 8.0% expressed quitting interest; and 2.4% consented to fax referrals. Findings suggest integration of a practice-based HelpLine fax referral process is feasible in health care delivery settings for both patients and household tobacco users.