Improving smoking cessation counseling using a point-of-care health intervention tool (IT): From the Virginia practice support and research network (VaPSRN)

Purpose: primary care practices are an ideal setting for reducing national smoking rates because >70% of smokers visit their physician annually,yet smoking cessation counseling is inconsistently delivered to patients. we designed and created a novel software program for handheld computers and hypothesized that it would improve clinicians' ability to provide patient-tailored smoking cessation counseling at the point of care. methods: a handheld computer software program was created based on smoking cessation guidelines and an adaptation of widely accepted behavioral change theories. the tool was evaluated using a validated before/after survey to measure physician smoking cessation counseling behaviors,knowledge,and comfort/self-efficacy. results: participants included 17 physicians (mean age,41 years; 71% male; 5 resident physicians) from a practice-based research network. after 4 months of use in direct patient care,physicians were more likely to advise patients to stop smoking (p = .049) and reported an increase in use of the 5 as (p = .03). improved self-efficacy in counseling patients regarding smoking cessation (p = .006) was seen,as was increased comfort in providing follow-up to patients (p = .04). conclusions: use of a handheld computer software tool improved smoking cessation counseling among physicians and shows promise for translating evidence about smoking cessation counseling into practice and educational settings.