Electronic medical record reminders and smoking cessation activities in primary care

Abstract

Purpose: The purpose of this paper is to assess electronic medical record (EMR) automatic reminder use in relation to smoking cessation activities among primary-care providers.

Background: Primary-care physicians are in the frontline of efforts to promote smoking cessation. Moreover, doctors' prescribing privileges give them additional tools to help patients successfully quit smoking. New EMR functions can provide automated reminders for physicians to counsel smokers and provide prescriptions to support quit attempts.

Sample and methods: Logit regression is used to analyze the 2012 National Ambulatory Medical Care Survey (NAMCS). Variables related to the EMR's clinical reminder capability, patient's smoking status, the provision of cessation counseling and the prescribing of drugs that support quitting are analyzed.

Results: For primary care visit documents, smoking status was recorded 77.7% of the time. Smoking cessation counseling was ordered/provided 16.4% of the time in physicians' offices using electronic reminders routinely compared to 9.1% in those lacking the functionality. Smoking cessation medication was ordered/prescribed for 3.7% of current smokers when reminders were routinely used versus 2.1% when no reminder was used. All the differences were statistically significant.

Conclusions: The presence of an EMR equipped with automated clinical reminders is a valuable resource in efforts to promote smoking cessation. Insurers, regulators, and organizations promulgating clinical guidelines should include the use of EMR technology as part of their programs.

Keywords: Clinical reminders; Electronic medical records; Smoking cessation; Smoking counseling; Smoking prescriptions.