TY - JOUR
T1 - Care coordination to increase referrals to smoking cessation telephone counseling
T2 - A demonstration project
AU - Sherman, Scott E.
AU - Takahashi, Nancy
AU - Kalra, Preety
AU - Gifford, Elizabeth
AU - Finney, John W.
AU - Canfield, James
AU - Kelly, John F.
AU - Joseph, George J.
AU - Kuschner, Ware
PY - 2008/3
Y1 - 2008/3
N2 - Objective: To test the effectiveness of a care coordination program for telephone counseling in raising referral and treatment rates for smoking cessation. Study Design: A demonstration project implementing a smoking cessation care coordination program offering telephone counseling and medication management to patients referred from primary care. Methods: The study was performed at 18 Veterans Health Administration (VA) sites in California. Participants were VA patients receiving primary care. We randomly allocated 10 of 18 sites to receive the Telephone Care Coordination Program, which included simple 2-click referral, proactive care coordination, medication management, and 5 follow-up telephone calls. Each patient received a 30- to 45-minute counseling session from the California Smokers' Helpline. Patients at control sites received usual care. Results: During 10 months, we received 2965 referrals. We were unable to reach 1156 patients (39%), despite at least 3 attempts. We excluded 73 patients (3%), and 391 patients (13%) were not interested. We connected the remaining 1345 patients (45%) to the Helpline. At 6-month follow-up, 335 patients (11% of all referrals and 25% of participating patients) were abstinent. Providers at intervention sites reported referring many more patients to telephone counseling than providers at control sites (15.6 vs 0.7 in the prior month). Conclusions: The program generated a large number of referrals; almost half of the patients referred were connected with the Helpline. Long-term abstinence was excellent. These results suggest that managed care organizations may be able to improve tobacco control by implementing a similar system of care coordination.
AB - Objective: To test the effectiveness of a care coordination program for telephone counseling in raising referral and treatment rates for smoking cessation. Study Design: A demonstration project implementing a smoking cessation care coordination program offering telephone counseling and medication management to patients referred from primary care. Methods: The study was performed at 18 Veterans Health Administration (VA) sites in California. Participants were VA patients receiving primary care. We randomly allocated 10 of 18 sites to receive the Telephone Care Coordination Program, which included simple 2-click referral, proactive care coordination, medication management, and 5 follow-up telephone calls. Each patient received a 30- to 45-minute counseling session from the California Smokers' Helpline. Patients at control sites received usual care. Results: During 10 months, we received 2965 referrals. We were unable to reach 1156 patients (39%), despite at least 3 attempts. We excluded 73 patients (3%), and 391 patients (13%) were not interested. We connected the remaining 1345 patients (45%) to the Helpline. At 6-month follow-up, 335 patients (11% of all referrals and 25% of participating patients) were abstinent. Providers at intervention sites reported referring many more patients to telephone counseling than providers at control sites (15.6 vs 0.7 in the prior month). Conclusions: The program generated a large number of referrals; almost half of the patients referred were connected with the Helpline. Long-term abstinence was excellent. These results suggest that managed care organizations may be able to improve tobacco control by implementing a similar system of care coordination.
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M3 - Article
C2 - 18333706
AN - SCOPUS:40549132245
SN - 1088-0224
VL - 14
SP - 141
EP - 148
JO - American Journal of Managed Care
JF - American Journal of Managed Care
IS - 3
ER -