NEWS | November 7, 2019

Automated quitline referrals help patients give up tobacco


Electronic health record (EHR) systems that house patient medical histories can also easily link them with telephone quitlines that improve their chances of permanently giving up tobacco, new UC Davis Health and UC San Diego research shows.

Elisa Tong Elisa Tong

The authors based their analysis on the first three years of UC Davis Health’s e-referral system to their state’s quitline ― the California Smokers’ Helpline.

The e-referral module was designed to be easy to launch and use within UC Davis' existing EHR system. With permission, physicians securely sent patient information directly to the Helpline. A counselor then followed up within a couple of days to initiate an intervention.

The results are now published in the journal Applied Clinical Informatics. Between 2013 and 2016, 16,083 primary care, specialty care and hospital physician encounters with smokers resulted in 1,137 e-referrals to the Helpline. About one-fifth ― or 21.9% ― of patients who had a 6- to 12-month follow-up appointment reported quitting smoking.

“Automated referrals add to the list of what we can do to help patients who use tobacco,” said senior author Elisa Tong. “It can take 8 to 12 attempts to quit for good, so every time a patient sees a doctor is an important opportunity to help.”

Tong is a general internal medicine physician at UC Davis Health. She also is medical director for the UC Davis Comprehensive Cancer Center’s Stop Tobacco Program. Her research focuses on finding effective ways to help patients quit tobacco and reduce their risks of cancer, heart disease, stroke, type 2 diabetes and COPD.

Quitlines, she said, tend to be useful for those who prefer the privacy or convenience of telephone counseling to in-person counseling or classes.

“We want to encourage all evidence-based options for patients until they find the path to quitting that works for them,” Tong said.

UC Davis Health’s quitline e-referral system is now being shared with other California health systems. Tong and her team also are hoping to share the program with Federally Qualified Health Centers, which serve low-income populations with higher smoking prevalence rates than the general population.

Tong's collaborators were lead author Eve Angeline Hood-Medland, Hien Nguyen, Mark Avdalovic and Scott MacDonald of UC Davis Health, and Shu-Hong Zhu and Antonio Mayoral of the California Smokers’ Helpline at UC San Diego. 

Their study was funded by the California Tobacco Control Program, U.S. Health Resources and Services Administration and University of California Office of the President. 

Reporters can request a copy of “Health System Implementation of a Tobacco Quitline eReferral” from the journal: