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• W4387247788 abstract "SESSION TITLE: Cannabis and Tobacco: Behind the Smoke Screen SESSION TYPE: Original Investigations PRESENTED ON: 10/10/2023 01:45 pm - 02:45 pm PURPOSE: Smoking is the leading cause of preventable disease and death in the United States. When used separately or in combination, smoking cessation counseling and cessation medications have been associated with increased cessation rates. In addition, smoking related screening such as low-dose computed tomography (LDCT) and abdominal aortic aneurysm ultrasound (AAA) are indicated in smokers who meet screening criteria and have shown mortality benefits. The purpose of this study is to investigate trends in both primary care provider driven smoking cessation and smoking-related screening interventions and how patient factors impact the rate of intervention. Our findings will help the development of a smoking cessation and screening electronic health record based intervention. METHODS: Using the inclusion criteria of 18 years or older and current smoker status, a total of 94,785 encounters from an academic health system over 2 years (2021-2022) were analyzed. During these encounters we determined the rate at which smoking cessation counseling was billed and the rate of prescription for smoking cessation related medications. Individual patients were reviewed for criteria appropriate screening with LDCT (n= 1972 eligible) and AAA (n=404 eligible). We then compared these data based on race and insurance status. RESULTS: Of the encounters, only 0.9% resulted in billing for smoking cessation and 3.4% of encounters resulted in at least one cessation medication prescription. With regards to LDCT, 13.2% of eligible patients had screening ordered. With regards to AAA screening, 7.7% of eligible patients had screening ordered. We found significant differences between racial groups when it came to the rate of smoking cessation billing (p=0.001), medication prescription(p=0.001) but not for LDCT(p=0.312) or AAA(p=0.635). With regards to insurance status, we found significant differences between groups when it came to the rate of smoking cessation billing (p=0.001), medication prescription (p=0.001), and LDCT (p=0.003), but not AAA (p=0.944). Group sub-analyses are pending. CONCLUSIONS: Overall, the rate of smoking cessation intervention and smoking-related screening in primary care was low, and provider efforts are not being properly billed, given the discrepancy between the rate of medication prescription and counseling. We found significant differences in the rate of smoking cessation intervention and smoking related screening based on sociodemographic factors of race and insurance status CLINICAL IMPLICATIONS: Our assessment showed potential areas for improvement in delivery of smoking-related care, as well as significant under-capturing of provider efforts related to smoking cessation counseling. We also identified variations in care based on demographic and payer status which may perpetuate health disparities. A bundled clinical decision support tool may help improve delivery and billing of smoking related care. DISCLOSURES: No relevant relationships by Paula Brown No relevant relationships by Richa Bundy EHR Consultant for the AAMC CORE Program relationship with EHR Consultant for the AAMC CORE Program Please note: Longitudinal Added 03/29/2023 by Ajay Dharod, source=Web Response, value=EHR Consultant for the AAMC CO Co-inventor of WHIRL Software licensed relationship with IllumiCare Please note: Longitudinal Added 03/29/2023 by Ajay Dharod, source=Web Response, value=None yet Co-inventor of mPATH software licensed relationship with Digital Health Navigation Solutions Please note: longitudinal Added 03/29/2023 by Ajay Dharod, source=Web Response, value=ownership interest No relevant relationships by John Gehris No relevant relationships by Chris Kelly No relevant relationships by Adam Moses No relevant relationships by Dustin Norton No relevant relationships by Corey Obermiller No relevant relationships by Erin Sutfin No relevant relationships by Lauren Witek" @default.
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• W4387247788 date "2023-10-01" @default.
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• W4387247788 title "QUANTIFYING SMOKING CESSATION INTERVENTIONS AND SMOKING-RELATED SCREENING IN THE PRIMARY CARE SETTING" @default.
• W4387247788 doi "https://doi.org/10.1016/j.chest.2023.07.4110" @default.
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