FINDINGS AND FUTURE DIRECTIONS FROM A SMOKING CESSATION TRIAL UTILIZING A CLINICAL DECISION SUPPORT TOOL

Area of Science:

• Public Health
• Dental Medicine
• Health Informatics

Background:

• Tobacco smoking is a leading cause of preventable death and disease in the U.S.
• Dental practitioners are encouraged to offer smoking cessation interventions.
• Brief advice delivery by dental professionals is often insufficient.

Purpose of the Study:

• To evaluate if a clinical decisions support (CDS) system integrated into electronic dental records can increase smoking cessation intervention rates among dental patients.
• To assess the impact of the CDS system on patient-reported interventions, subsequent cessation actions, and sustained smoking reduction.

Main Methods:

• A cluster-randomized trial involving 15 dental clinics from March to December 2019.
• Clinics were randomized to either usual care or a CDS system arm.
• Adult smokers completed telephone surveys at 7 days and 6 months post-visit.

Main Results:

• Patients in the CDS arm reported significantly higher rates of receiving brief interventions or referrals (84.3% vs. 58.6%, P=.005).
• While trends favored the CDS arm, statistically significant differences were not observed for short-term cessation actions (44.4% vs. 22.3%) or 6-month cessation/reduction outcomes (63.1% vs. 46.2%).

Conclusions:

• The CDS system shows potential for improving smoking cessation support within dental settings.
• This approach can assist dental practitioners in screening, intervening, and referring patients for smoking cessation.
• Further research may be warranted to optimize CDS integration and impact on long-term cessation.