Characteristics of Patients Engaging in Quitline Counseling After an Electronic Referral.
Thursday, July 15, 2021
Posted by: Natalia Gromov
Flocke SA, Albert EL, Lewis
SA, Seeholzer EL, Bailey SR.
Characteristics of
Patients Engaging in Quitline Counseling After an Electronic Referral.
Am J Prev Med. 2021 Jun 13:S0749-3797(21)00237-3. doi:
10.1016/j.amepre.2021.03.019. Epub ahead of print. PMID: 34134884.
Introduction.
Proactive, electronic referral of primary care patients to quitlines has great
potential to provide evidence-based tobacco-cessation assistance to tobacco
users. However, the quitline contact rates and engagement of individuals beyond
1 counseling call are poor. This study examines the characteristics of
electronically referred patients who engage with the quitline.
Methods. This
cross-sectional study included 2,407 primary care patients who reported using
tobacco and accepted an electronic referral to the quitline. Outcomes included
contact, enrollment, and receipt of ≥2 counseling sessions from the quitline.
All measures were assessed from the electronic health record. The association
of patient characteristics and outcomes was evaluated using logistic regression
modeling with generalized estimating equation methods. Data were collected in
2016‒2018 and were analyzed in 2020.
Results. Among
2,407 referred patients, 794 (33.0%) were contacted; of those, 571 enrolled
(71.9%); and of those, 240 (42.0%) engaged in ≥2 quitline counseling sessions.
In multivariable analyses, older adults (aged 50-64 and ≥65 years) were
significantly more likely to be contacted (OR=2.32, 95% CI=1.6, 3.4) and to
receive ≥2 counseling sessions (OR=2.34, 95% CI=1.2, 4.7) than those aged 18-34
years. Those with both Medicare and Medicaid insurance coverage were more
likely than those with Medicaid only to be contacted (OR=1.71, 95% CI=1.4,
2.2), to enroll (OR=1.84, 95% CI=1.2, 2.9), and to receive ≥2 counseling
sessions (OR=1.83, 95% CI=1.2, 2.9).
Conclusions.
The current quitline phone-based approach is less likely to engage younger
adults and those with Medicaid coverage; however, there is a need to improve
quitline engagement across all patients. Identification and testing of
alternative engagement approaches are needed.
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