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A Collaborative Model for Facilitating the Delivery of Smoking Cessation Treatments to Cancer Patients: Results From Three Oncology Practices in South Carolina

Published online by Cambridge University Press:  10 July 2018

Daniel J. Kilpatrick Open the ORCID record for Daniel J. Kilpatrick [Opens in a new window] ,
Kathleen B. Cartmell ,
Abdoulaye Diedhiou ,
K. Michael Cummings ,
Graham W. Warren ,
Kathleen L. Wynne ,
Sharon R. Biggers  and
Pamela S. Gillam
Daniel J. Kilpatrick*
Affiliation:
Division of Tobacco Prevention and Control, SC Department of Health and Environmental Control, Columbia, SC
Kathleen B. Cartmell
Affiliation:
College of Nursing, Medical University of South Carolina, Charleston, SC
Abdoulaye Diedhiou
Affiliation:
Division of Tobacco Prevention and Control, SC Department of Health and Environmental Control, Columbia, SC
K. Michael Cummings
Affiliation:
Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC
Graham W. Warren
Affiliation:
Department of Radiation Oncology, Medical University of South Carolina, Charleston, SC
Kathleen L. Wynne
Affiliation:
Division of Tobacco Prevention and Control, SC Department of Health and Environmental Control, Columbia, SC
Sharon R. Biggers
Affiliation:
Division of Tobacco Prevention and Control, SC Department of Health and Environmental Control, Columbia, SC
Pamela S. Gillam
Affiliation:
Arnold School of Public Health, University of South Carolina, Columbia, SC
*
Address for correspondence: Daniel J. Kilpatrick, PhD, MPH, Division of Tobacco Prevention and Control, SC Department of Health and Environmental Control, 2100 Bull Street, Mills/Jarrett Complex, Columbia, SC29201. Email: kilpatdj@dhec.sc.gov
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Abstract

Introduction: Continued smoking by cancer patients causes adverse cancer treatment outcomes, but few patients receive evidence-based smoking cessation as a standard of care.

Aim: To evaluate practical strategies to promote wide-scale dissemination and implementation of evidence-based tobacco cessation services within state cancer centers.

Methods: A Collaborative Learning Model (CLM) for Quality Improvement was evaluated with three community oncology practices to identify barriers and facilitate practice change to deliver evidence-based smoking cessation treatments to cancer patients using standardized assessments and referrals to statewide smoking cessation resources. Patients were enrolled and tracked through an automated data system and received follow-up cessation support post-enrollment. Monthly quantitative reports and qualitative data gathered through interviews and collaborative learning sessions were used to evaluate meaningful quality improvement changes in each cancer center.

Results: Baseline practice evaluation for the CLM identified the lack of tobacco use documentation, awareness of cessation guidelines, and awareness of services for patients as common barriers. Implementation of a structured assessment and referral process demonstrated that of 1,632 newly registered cancer patients,1,581 (97%) were screened for tobacco use. Among those screened, 283 (18%) were found to be tobacco users. Of identified tobacco users, 207 (73%) were advised to quit. Referral of new patients who reported using tobacco to an evidence-based cessation program increased from 0% at baseline across all three cancer centers to 64% (range = 30%–89%) during the project period.

Conclusions: Implementation of quality improvement learning collaborative models can dramatically improve delivery of guideline-based tobacco cessation treatments to cancer patients.

Type
Original Articles
Information
Journal of Smoking Cessation , Volume 14 , Issue 2 , June 2019 , pp. 112 - 124
Copyright
Copyright © The Author(s) 2018 

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