Photography by Matt Miller, courtesy of Siteman Cancer Center and Washington University School of Medicine
Charis Baumgartner, a clinical nurse coordinator, completes a tobacco assessment of a patient at Siteman Cancer Center.
Through a grant from the National Cancer Institute, a new electronic records system, and a team of dedicated researchers, Siteman Cancer Center has increased its efforts to help patients stop smoking. Now, they'll ask more patients whether they smoke and then follow up with referrals for services that can help them quit or prescriptions for medications such as nicotine replacement therapy (patches, gum, etc.).
Though the program is still in its infancy, it already looks promising. Results from the first five months of the program were published in Translational Behavioral Medicine, a peer-reviewed medical journal, on July 17.
Of the 34,000 patients treated at Siteman, 48 percent of them were asked whether they smoke prior to the program's launch. Five months later, nearly 90 percent of the 24,000 patients were being asked. Under the new system, if a patient answers 'yes,' the electronic health records system automatically provides treatment options and recommendations that the patient can explore with the doctor in that same appointment.
"We're able to address multiple different preferences and ways of seeking care with a lighter touch, lower burden options that can be offered right there," says Dr. Alex Ramsey, an assistant professor of psychiatry and one of the study's principal authors.
Because it's now easier to let patients know in one appointment about strategies for quitting, more patients are being prescribed medication—a fivefold increase from 3 percent before the program to 17 percent now.
Ramsey says he hopes the program can be expanded to include the entire inpatient and outpatient networks through Washington University, Barnes Jewish, and BJC.
"We want that type of model where we're able to extend this care in a sustainable way across the system, which spans both urban and rural areas," Ramsey says. "We want this to be something that lower-resource rural areas are able to take advantage of, moving the needle in terms of their tobacco-use assessment and treatment with relatively little investment and highly accessible tools."
This one-stop-shop model especially benefits patients who don't live near high-quality medical facilities and may not be able to travel for multiple appointments. Ramsey hopes that giving those patients the tools they need to quit smoking while they are already on site will help strengthen their motivation. Even for patients who already suffer from advanced cancers, quitting smoking tomorrow would huge positive impacts on their health. It increases survival rates, prevents treated cancer from reoccurring, and lowers the risk of developing additional cancers. Ramsey says one of the biggest positive outcomes is also the least emphasized: quitting can decrease the negative side effects from cancer treatments, such as radiation and chemotherapy.
"[Quitting] is really one of the most important things that someone who smokes can do to help fight their cancer," Ramsey says. "We want to have the highest impact possible, and just continue to scale those benefits even more broadly."
